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APWU Health Plan is a National Preferred Provider Organization (PPO) offering both a fee-for-service High Option Health Plan and a Consumer Driven Option Health Plan. We have been proudly serving America's workforce since 1960.Compare Plan Options See Premiums See Provider Networks See 2017 Federal Brochure
- HIGH OPTION
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New members can enroll during Open Season in the fall, or within 60 days of new employment, or for a qualifying life event.How to Enroll
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Email your resume and cover letter to firstname.lastname@example.org.
The APWU Health Plan is seeking a Trainer/Procedures Analyst to join our Training, Productivity and Testing Department.
This position supports production areas by developing and delivering accurate operational reference material, training programs, and procedures.
- Design and conduct in-house training.
- Prepare training and procedure manuals.
- Evaluate training and development effectiveness.
- Develop and implement project plans and meet target dates.
- Perform other duties as assigned.
- AA degree (or commensurate experience) preferred.
- Thorough understanding of all Health Plan processing systems (e.g. HEALTHsuite, Formworks, Macess EXP, QNXT, NICE, etc.).
- Must be skilled in techniques and procedures associated with development, implementation and presentation of training programs.
- Thorough knowledge and comprehension of operational procedures and ability to analyze and write operational procedures.
- Experience in processing claims, handling member and provider calls, familiarity with Health Plan enrollment, provider file, data entry and mail sort areas.
- Ability to work independently and to coordinate workshops and seminars.
- Excellent verbal and written communication skills.
The APWU Health Plan is seeking a HEDIS CAHPS Program Manager. This position is responsible for HEDIS and CAHPS project management in collaboration with other key departments and external vendors and auditors. This will include year-round monitoring and annual required reporting.
- Develop and manage annual HEDIS and CAHPS project plans; monitor project(s)' progress and timeliness to ensure deadlines are met.
- Coordinate all aspects of the HEDIS data collection in order to identify and close data collection gaps with the intent to increase HEDIS and CAHPS rates.
- Ensure compliance with both HEDIS and CAHPS technical specifications, policies, operating procedures, and goals.
- Identify process improvement opportunities.
- Serve as a primary HEDIS and CAHPS contact for external and internal inquiries and, as such, manage vendor and auditor relationships.
- Collaborate with departments to design, implement and monitor effectiveness of interventions.
- Other duties as assigned.
- Bachelor Degree - healthcare, business, mathematics, or applied stats/economic concentration. At least five years' experience in the health care field. The equivalent combination of education and experience will be considered.
- Minimum of 2-3 years of HEDIS and/or CAHPS project management, coordination, and data collection experience.
- Ability to manage multiple, complex projects with strict HEDIS and CAHPS deadlines.
- Demonstrated analytical ability in identifying problems, developing solutions and implementing effective courses of action.
- Demonstrated ability to work effectively and productively with varied levels of personnel and with professionals and business organizations individually or in a group setting.
- Strong communication skills required, including the abilities to effectively communicate verbally and in writing, internally and externally, and at different levels as necessary.
- Applied knowledge in a business healthcare setting of quality improvement, research, and statistics. Extensive knowledge of regulatory requirements.
- Familiarity with the NCQA on-line reporting tool called Quality Compass.
- Strong knowledge MS Office and Project Management tools.