At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders -- internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity and empower each other to illuminate our collective potential.
Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!! JOB SUMMARY:
An OON Analyst is essential for ensuring a company's daily operations run smoothly and efficiently. Their role involves a range of tasks, including managing workflow distribution, claim reassignment, data tracking, daily reporting, and maintaining standard spreadsheets. They also provide support and oversight to various departmental queues. Serving as a key link between departments, the OON Analyst plays a pivotal role in achieving the organization's operational goals and promoting growth.
JOB ROLES AND RESPONSIBILITIES:
1. Operational Documentation and Consistency
* Design and maintain clear operational guides to ensure consistent processes.
* Assist in coordinating day-to-day operations to ensure effective and efficient delivery service.
2. Workflow and Claims Management
* Manage manual distribution of claims or workflow when automated systems are unavailable.
* Track the completion and outcomes of assigned tasks within the team.
* Investigate queue and reporting workflows for efficiency improvements and distribution opportunities.
* Manage schedules, meetings, and communications, ensuring proper documentation and timely follow-ups.
3. Data Analysis and Reporting
* Research historical performance to provide analytics on team outcomes.
* Maintain departmental reports to increase claim monetization, improve quality, and identify revenue opportunities.
* Analyze and maintain departmental reports to improve data quality, identify distribution opportunities, and manage workflow.
* Provide ad hoc reports upon request.
4. Process Improvement
* Observe and analyze processes to identify inefficiencies and suggest improvements.
* Recommend changes to systems and operations to optimize workflow efficiency.
* Support project planning, track progress, and ensure deadlines are met, working closely with cross-functional teams.
* Investigate queue and reporting workflows for efficiency improvements and distribution opportunities.
* Assist with special projects, prioritizing and shifting focus as needed while maintaining daily workload.
5. Collaboration and Communication
* Work closely with managers and coordinate with team leaders, and department heads to manage inventory and maintain distribution levels.
* Facilitate feedback from team members and management and executive teams.
* Present solutions and recommendations to management regularly.
* Collaborate with management and executives to set departmental and organizational goals.
6. Issue Resolution and Internal Service
* Assist peers and department heads in resolving issues or inquiries.
* Assist with team inquiries and resolve operational issues to ensure department satisfaction.
* Deliver reports to management and executives, providing insights into operational efficiency.
7. Training and Peer Support
* Train peers on established processes as needed.
* Back up daily workflows for peers when required.
* Support project planning, track progress, and ensure deadlines are met by working closely with cross-functional teams.
8. Operational Oversight and Efficiency Improvement
* Observe, review, and analyze processes to identify inefficiencies and areas for improvement.
* Recommend changes to systems and operations to improve workflow efficiency within the department.
* Maintain accurate records, monitor performance metrics, and prepare operational reports for management.
9. Compliance and Safety
* Demonstrate the company's core competencies and values in all activities.
* Handle sensitive data responsibly due to the high-risk nature of the role.
* Assist with other duties, responsibilities, and qualifications as assigned.
* Ensure compliance with HIPAA regulations, company policies, and industry standards.
* Ensure all operations conform to local, federal, and industry regulations.
* Recognize that this is a high-risk role due to exposure to PHI (Protected Health Information) and ensure compliance with all relevant regulations.
* Ensure that all activities comply with local, federal, industry, and company standards, including HIPAA regulations.
* Maintain adherence to organizational policies and safety protocols.
* Perform other duties as assigned to meet the needs of the organization. JOB SCOPE:
Individual works under general supervision to complete job responsibilities in applying knowledge of the department processes and impacts of decisions made to workload and workflow. Work involves applying advanced skills using tools, systems and tools for the position or specialization. Duties and tasks are standardized and the individual resolves routine questions and issues while referring more complex issues to higher levels for resolution.
|
MultiPlan
Apr 06, 2026