- Operating Rules
- CORE Certification
- Value-Based Payments
- Industry Topics and Comment Letters
- Education and Implementation Resource Center
- HHS HIPAA Compliance
- Join CORE
- Provider Data Management
- CAQH ProView
- Provider Directory - DirectAssure
- COB Smart
- Provider Data Management
- CAQH Index
- Provider Data Collaboration
Senior Associate, CORE
Senior Associate, CORE
Monday, July 23, 2018
Tuesday, July 23, 2019
Supports the day-to-day activities of the Committee on Operating Rules for Information Exchange (CORE), an initiative of CAQH. Serves a critical role in assisting the healthcare industry with the development and implementation of healthcare operating rules to address critical topics including prior authorization, healthcare payments, value-based payment, etc. Supports the management of CAQH CORE work groups which includes representatives from health plans, providers, vendors/clearinghouses, associations, consulting firms and government entities. Role includes content development and administrative support including research projects, group management and planning, materials development and implementation tools. This is a full-time exempt position.
- Researches, designs and drafts content for CAQH CORE Work Groups, which develop and maintain healthcare industry operating rules.
- Develops analysis strategies, research summaries, Work Group facilitation documents and draft rule recommendations, in collaboration with subject matter experts.
- Develops critical tools to assist the industry with implementation and maintenance of the CAQH CORE Operating Rules.
- Provides daily management of CAQH CORE Work Groups.
- Creates and manages task lists to track the internal document development and review cycle for Work Group work products. Uses existing work plans to organize and track Work Group progress; updates work plans as needed and identifies and communicates any impacts of updates to schedule or scope.
- Provides scheduling, logistical oversight and meeting organization for work groups and related meetings (e.g., Co-Chair Prep Calls, Work Group Calls, etc.).
- Serves as a primary contact for CAQH CORE Work Group members who have questions regarding timelines, documents, and meeting agenda items.
- Maintains accurate and up-to-date lists of Work Group organizations and individual contacts in customer relationship management tool; uses the participation data to track and analyze participant engagement and monitor support levels throughout the rule development process; proactively provides recommendations to Manager as needed.
- Supports communication with and outreach to external industry organizations (health plans, healthcare providers, vendors, government entities, etc.).
- Drafts and provides timely responses to inquiries from industry organizations regarding operating rule requirements, implementation, policy questions, and tools/resources. Escalates significant issues to appropriate staff and develops recommendations for organizational enhancements based on understanding of evolving CAQH CORE member needs.
- Creates presentations overviewing CAQH CORE projects and industry trends for external organizations (e.g., industry conferences, presentations to federal advisory committees, etc.)
Knowledge, skills and abilities:
- Desire and ability to learn new and challenging content areas.
- Strong qualitative and quantitative analytic capabilities to compile, distill and interpret data for broader audiences.
- Ability to take complex topics and synthesize into user-friendly documents/tools.
- Ability to simultaneously perform multiple assignments and follow extensive work plans.
- Excellent attention to detail and organizational skills.
- Excellent writing skills with the ability to translate technical concepts into business language as needed.
- Ability to outline slide flow and content, and develop formal PowerPoint presentations to convey information effectively for executive audiences.
- Excellent interpersonal communication skills.
- Strong experience in Microsoft Word, PowerPoint and Excel.
- Experience with Salesforce and/or other customer relationship management database software desired.
- Experience with survey development and analysis software – preferably Qualtrics – desired.
- Is inspired by the work of CAQH CORE and motivated to have a positive impact on simplifying the business of healthcare. Maintains an intellectual curiosity about how to accomplish this goal through industry collaboration.
- Four years of related work experience in the healthcare industry, preferably in healthcare consulting or policy. Exposure to requirements gathering and development a plus.
- Knowledge of the healthcare revenue cycle and the key parties involved is desirable.
- Bachelor’s degree required; business and technology disciplines preferred.
- Master's level class work and/or degree in healthcare policy, healthcare administration, or a related field is desirable.
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WHAT YOU GET:
CAQH recognizes that its most important asset is its growing team of smart, creative, collaborative, forward-thinking and passionate professionals – and that a comprehensive employee benefits package is an important factor for them in choosing where to work. CAQH offers competitive compensation along with an extensive benefits package for all full-time employees, including medical, dental and vision coverage, tuition assistance and a 401k. Our location in downtown Washington, DC is metro-accessible, has an onsite fitness center and is centrally located to allow our team to take advantage of professional networking opportunities, cultural offerings and a thriving social scene.
Who we are:
Named one of the "Best Places to Work" by Modern Healthcare for three consecutive years, CAQH, a non-profit alliance, is the leader in creating shared initiatives to streamline the business of healthcare. Through collaboration and innovation, CAQH accelerates the transformation of business processes, delivering value to providers, patients and health plans. Our initiatives include:
- COB Smart® quickly and accurately directs coordination of benefits processes.
- EnrollHub® reduces costly paper checks with enrollment for electronic payments and electronic remittance advice.
- CAQH ProView® eases the burden of provider data collection, maintenance and distribution.
- DirectAssure® increases the accuracy of health plan provider directories.
- VeriFideTM streamlines credentialing by consolidating and standardizing primary source verification.
- SanctionsTrack® delivers comprehensive, multi-state information on healthcare provider licensure disciplinary actions.
- CAQH CORE® maximizes business efficiency and savings by developing and implementing national operating rules.
- CAQH Index® benchmarks progress and helps optimize operations by tracking industry adoption of electronic administrative transactions.