STRS Ohio, STRS
The State Teachers Retirement System of Ohio (STRS Ohio) is seeking a Health Care Audit and Training Coordinator to join its Health Care Production Operations team.Established in 1920 and serving Ohio’s educators, STRS Ohio is one of the nation’s largest retirement systems, serving over 500,000 active, inactive, and retired public-school teachers, and university faculty members, managing approximately $96.9 billion as of June 30, 2024, in assets and paying more than $7 billion in benefits annually.STRS Ohio provides a competitive pay, and a comprehensive benefits package including on-site parking, educational assistance, subsidized medical insurance, fully paid dental and life insurance, vacation and sick leave, retirement benefits and on-site fitness center. At STRS Ohio, you can experience rewarding work in a professional, business casual work environment.
We welcome, celebrate, and promote respect for everyone. We are continually seeking bright and talented individuals to join our team.
Compensation:
$74,520 - $89,424
Work Schedule:
8:00am-5:00pm Monday through Friday (Onsite)
General Summary:
Under the direction of the assistant director, Health Care Internal Operation, audit premium billing, operational reports, workflows and processes to ensure accuracy in eligibility, enrollment and premiums. Develop and deliver training programs on technical system functionality, Medicare requirements, business rules, processes and procedures.
Summary of Responsibilities:
- Conduct audits of health care operations, workflows, reports and processes to ensure compliance with Administrative Rules and Centers for Medicare and Medicaid Services CMS regulations.
- Audit member coverage issues as result of Medicare enrollment/disenrollment in the Medicare Advantage Plan and Part D plan. Process reports and serve as back up for key operational tasks as needed.
- Provide audit results and constructive feedback to the assistant director, Health Care Internal Operations and health care associates in a collaborative manner.
- Develop and conduct training programs for Health Care Operations and representatives on internal operational processes, Administrative Rules and system functionality.
- Coordinate and facilitate training sessions, ensuring they meet departmental and regulatory requirements.
- Develop, review and maintain internal operations training materials and processing procedures to support ongoing operational improvements.
- Serve as a backup for Health Care Operation associates, assisting with workflows and processing key reports as directed.
- Handle escalated and complex issues requiring in-depth policy review and coordination with department managers.
The above list of duties is intended to describe the general nature and level of work performed by persons assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the persons so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct and control the work of associates under supervision.
Summary of Qualifications:
- High school diploma or equivalent is required.
- Bachelor’s degree in a related field preferred.
- Demonstrated ability to analyze information received from members or other individuals and found in the member record to appropriately apply business rules to process requests.
- Proven facilitation and leadership skills; ability to support management in leading initiatives and changes in a work environment that encourages associates to do their best and generates positive team spirit and morale required.
- Excellent math and analytical skills required.
- Excellent oral and written communication skills required.
- Interpersonal skills necessary to deal effectively and courteously with internal and external contacts required.
- Excellent organizational skills and a high degree of accuracy and attention to detail required. Ability to explain errors in a helpful manner.
Equal Employment Opportunity Employer Statement
State Teachers Retirement System of Ohio (STRS) is an Equal Employment Opportunity Employer and prohibits discrimination and harassment of applicants or employees on the basis of race, color, religion, gender, gender identity or expression, national origin (ancestry), military status, disability, age, genetic information, sexual orientation, or caregiver status, in making employment-related decisions about an individual.
ADA Statement
STRS Ohio is committed to ensuring access, inclusion, and reasonable accommodations across all its services, activities, programs, and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.
