Hybrid Associate Operations Correspondence Analyst

at Sun Life

• Job title: Associate Operations Correspondence Analyst
• Job type: Full Time
• Experience level: Junior, Mid level
• Salary: $54,000 - $72,900 per year
• Degree requirement: Associate's Degree
• Location requirements: Hybrid, Hartford, United States

About the role

• Associate Operations Correspondence Analyst focusing on managing templates and correspondence for compliance at DentaQuest. Balancing in-office collaboration with remote work flexibility.

Responsibilities

• Manage efforts to implement and revise correspondence, resulting from operation activity for utilization management, claims, and complaints/grievance/appeals, to ensure accurate content within the templates and the templates are implemented or revised within the timelines required.
• Completion of the client requirement document (CRD) to accurately reflect contract and regulatory requirements.
• Presentation of the CRD content to the client.
• Coordinate revisions necessary to final completion and client approval.
• Identify the templates required for implementation, based on operational process and requirements.
• Draft a template document, as necessary.
• Ensure template content meets requirements based on client contract, regulations, NCQA and/or URAC.
• Perform gap analysis for correspondence requirements and system functionality and/or current process and develop strategic solutions to ensure compliance with requirements.
• Coordinate template implementation and revisions with the client, client services, operations, the correspondence technical team and the Operations Correspondence Senior Manager.
• Define the rules necessary to accurately populate variable information within the template.
• Communicate the rules effectively to the correspondence technical team.
• Mock up samples of the templates and submit to the correspondence technical team to draft production samples.
• Define the parameters to be utilized to produce the samples, when necessary.
• Review production samples provided to ensure accuracy.
• Obtain approval from the client of the production samples.
• Coordinate through client services, as necessary.
• Coordinate production of the template with the correspondence technical team after approval has been received.
• Coordinate with the Operations Correspondence Senior Manager to create cases to test triggers for templates for complaint/grievance/appeals.
• Obtain translation of template content into non-English language(s), as necessary.
• Audit production samples of the letter files once the template is put into production.
• Communicate all template implementation and revisions to the applicable operational department.
• Audit templates periodically to ensure most recent approved template is in production.
• Assist the Operations Correspondence Senior Manager to determine root cause for all findings identified in an external audit, relating to correspondence.
• Correct errors identified by the UM Administrative Coordinators relating to mapping to citations and member denial language.
• Create and maintain a letter library and tracking mechanism for all current and historical templates for each client.
• Documentation to include client approval and the version of the template that is approved.
• Complete the process for Notice of Action (NOA) letters that require modification prior to mailing to the member to ensure modifications completed are accurate and completed timely.
• Cultivate and maintain professional relationships with both internal and external customers; communicate effectively with both internal and external customers using various methods of communication, including email, conference call, and video conferencing.
• Demonstrate a detailed understanding of requirements for correspondence for operations, as listed in individual client contracts and in federal and/or state regulations.
• Demonstrate a detailed understanding of DentaQuest policies and processes for correspondence for operations.
• Participate in market meetings to understand client requirements and changes.
• Communicate any items that impacts correspondence.
• Other duties as needed or required.

Requirements

• Associate degree in business, healthcare or related field (or equivalent work experience)
• Proficient with general computer software including Microsoft Excel, Word and Outlook.
• Exceptional communication skills and the ability to communicate appropriately at all levels of the organization.
• Excellent spirit for teamwork, problem-solving, communication, and decision-making skills.
• Strong situational analysis and decision-making abilities.
• Excellent verbal, written, interpersonal, organizational and public speaking/communication skills.
• Ability to prioritize and organize multiple tasks with tight deadlines.
• Minimum 3 years demonstrated experience managing multiple complex tasks with varying deadlines and competing priorities.
• Ability to work closely with internal business partners to ensure project completion.
• Previous experience managing template documents.
• Previous experience in professional or academic research.
• Demonstrated experience managing relationships with internal/external customers and working closely with the external customer to implement processes.

Benefits

• Generous vacation and sick time
• Market-leading paid family, parental and adoption leave
• Medical coverage
• Company paid life and AD&D insurance
• Disability programs
• Partially paid sabbatical program
• 401(k) employer match
• Stock purchase options
• Employer-funded retirement account
• Flexible, inclusive and collaborative work environment