BQE Specialist

Who we are   

Founded in 1999 and headquartered in Central Ohio, we’re a privately-owned, independent healthcare navigation organization. We believe that no one should have to navigate the cost and complexity of healthcare alone, and we’re on a mission to make healthcare simpler and more effective for our millions of members. Our big-hearted, tech-savvy team fights to ensure that our members get the care they need, when they need it, at the most affordable cost – that’s why we call ourselves Healthcare Warriors®.    

We’re committed to building diverse and inclusive teams – more than 2,000 of us and counting – so if you’re excited about this position, we encourage you to apply – even if your experience doesn’t match every requirement.  

About the role   

The purpose of the BQE Specialist is to ensure accurate maintenance of benefit plans into the Benefit Quoting Engine (BQE); serves as a credible and reliable source of truth to the organization regarding benefit plans, plan design, and vendor integrations to ensure timely and accurate benefit quoting by our Care Coordinators and access to members and providers. This role includes the process of onboarding new clients, renewal of existing clients and ongoing client management.

Location: This position is located at our Dublin, OH campus with hybrid flexibility.  

What you’ll do   

Renewal/Ongoing Client Management

• Analyze plan documents as they relate to the medical, pharmacy benefits and various vendor integrations as it pertains to plan changes
• Accurately maintains and updates plan benefit changes
• Perform “Summary Plan Document” audits

Onboading

• Analyze plan documents as they relate to the medical / pharmacy benefits and various vendor integrations 

• Interpret plan design to input into BQE utilizing standard and consistent language across all Third Party Administrators, Pharmacy Benefit Managers and other Vendors.
• Oversee project plan, key tasks, milestones, and corresponding deadlines associated with the onboarding process
• Participate in benefit related conference calls and/or in-person meetings
• Input plan designs into BQE
• Perform peer audits to verify accuracy and output
• Other duties as assigned

What you’ll bring 

• Education: Bachelor’s degree preferred to minimum 1 year at Quantum Health in Care Coordination
• Well-developed oral and written communication skills
• Strong familiarity with Pivit, member sites and other Quantum systems
• Strong attention to detail
• Able to take a large number of tasks and prioritize them
• Willingness to do both challenging and unchallenging tasks with equal attention to detail
• Highly organized and able to work independently.
• Takes ownership of assigned duties, projects and goals
• Ability to make decisions that are timely and well thought out that achieve results consistent with business goals and organizational culture
• Ability to think inside the box as well as outside
• Ability to function as a team member with the working group and to interact professionally with other entities both internally and externally
• Protect and take care of our company and members’ data every day by committing to work within our company ethics and policies

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