Health Plan Operations Associate

The Role

Modern Health is looking to add a Health Plan Operations Associate to our team. In this role, you will help us maintain foundational systems and processes to support all aspects of health plan integration: member health plan eligibility checks, medical claim submissions, claim tracking, member payments, and other areas. This role reports to the Health Plan Operations Senior Manager.

This position is open to candidates residing in AL, AZ, AR, CT, DE, FL, GA, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WV, WI, WY.

What You’ll Do

• Track claims and denials through the entire claim lifecycle

• Manage and establish new systems to support claims processing and related areas

• Identify gaps in claims and reach out to providers for missing information

• Help members troubleshoot issues involving claims or eligibility

• Create documentation and training materials for the broader Ops team

• Provide reporting and other visibility into this function

• Complete other special projects as needed

Who You Are

• You have 1-2 years of relevant work experience (claims experience is a plus)

• You are highly detail-oriented and organized

• You are a structured thinker and love checking things off your to-do list

• You have excellent verbal and written communication skills

• You are a problem solver and are able to analyze, troubleshoot and resolve issues

• You enjoy working with different kinds of people and are great at building relationships

• You are a team player who enjoys identifying group pain points and improving them

• You are humble, scrappy, and thrive in fast-paced environments

Benefits

Fundamentals:

• Medical / Dental / Vision / Disability / Life Insurance 

• High Deductible Health Plan with Health Savings Account (HSA) option

• Flexible Spending Account (FSA)

• Access to coaches and therapists through Modern Health's platform

• Generous Time Off 

• Company-wide Collective Pause Days 

Family Support:

• Parental Leave Policy 

• Family Forming Benefit through Carrot

• Family Assistance Benefit through UrbanSitter

Professional Development:

• Professional Development Stipend

Financial Wellness:

• 401k

• Financial Planning Benefit through Origin

But wait there’s more…! 

• Annual Wellness Stipend to use on items that promote your overall well being 

• New Hire Stipend to help cover work-from-home setup costs

• ModSquad Community: Virtual events like active ERGs, holiday themed activities, team-building events and more

• Monthly Cell Phone Reimbursement

Equal Pay for Equal Work Act Information

Please refer to the ranges below to find the starting annual pay range for individuals applying to work remotely from the following locations for this role.

• Zone 1: San Francisco Bay Area and New York City Metro

• Zone 2: All other California locations and Seattle, WA

• Zone 3: All other New York locations, All other Washington locations, Washington DC, Austin, TX, CT, IL, MA, NH, NJ, OR, RI, VT

• Zone 4: All other Texas locations, AL, AK, AZ, AR, CO, DE, FL, GA, HI, ID, IN, IA, KS, KY, LA, ME, MD, MI, MN, MS, MO, MT, NE, NV, NM, NC, ND, OH, OK, PA, SC, SD, TN, UT, VA, WV, WI, WY

Compensation for the role will depend on a number of factors, including a candidate's qualifications, skills, competencies, and experience and may fall outside of the range shown. Ranges are not necessarily indicative of the associated starting pay range in other locations. Full-time employees are also eligible for Modern Health's equity program and incredible benefits package. See our Careers page for more information.

Depending on the scope of the role, some ranges are indicative of On Target Earnings (OTE) and includes both base pay and commission at 100% achievement of established targets.

Zone 1

$62,100—$73,000 USD

Zone 2

$55,900—$65,700 USD

Zone 3

$49,700—$58,400 USD

Zone 4

$46,600—$54,750 USD