Legal Operations Specialist Jobs in Utah

Overview

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA

The Health Plans Operations Specialist oversees projects and initiatives, conducts internal audits, and provides training to ensure accuracy and compliance. This role involves coordinating with various departments and vendors, implementing projects, and enhancing staff skills through auditing and effective training.

Corporate Overview: University of Utah Health is an integrated academic healthcare system with five hospitals including a level 1 trauma center, eleven community health centers, over 1,600 providers, and a health plan serving over 200,000 members. University of Utah Health is nationally ranked and recognized for our academic research, quality standards and overall patient experience. In addition to our clinical delivery system, we have a School of Medicine, School of Dentistry, College of Nursing, College of Pharmacy, and College of Health providing education and training for over 1,250 providers annually. We have over 2 million patient visits annually and research grants exceeding $350 million. University of Utah Hospitals and Clinics represents our clinical operations for the larger health system.

Responsibilities

Essential Functions

• Manage Clinical Operations projects to completion.
• Report on project progress and outcomes.
• Coordinate with external vendors and stakeholders.
• Evaluate progress of Clinical Operations initiatives and adjust as needed.
• Develop and implement Clinical Operations processes.
• Conduct internal audits to assess accuracy and completeness.
• Ensure compliance with internal controls, policies, and regulations.
• Identify areas for improvement and provide recommendations.
• Prepare audit reports and present findings.
• Design and develop training based on identified needs.
• Prepare and maintain educational materials.
• Collaborate with health plan leaders and other departments.
• Analyze data to identify trends and areas for improvement.
• Maintain updated records of educational materials.

Knowledge / Skills / Abilities

• Ability to perform essential job functions.
• Ability to analyze and document complex processes.
• Knowledge of project coordination.
• Computer, organizational, human relations, and communication skills.

Qualifications

Required

• Bachelor's degree, or equivalency.
• Two years of applicable experience.

Preferred

• Billing or Coding Certification through AAPC.
• Knowledge of and experience with Medicaid and Commercial insurance.
• Certification as a Project Management Professional (PMP).
• Advanced Excel Experience (pivot tables, Power Query, macros, VBA, Data Model).
• Trend identification and Root cause analysis.
• Performance metrics (KPIs, SLAs).
• Healthcare operations (preferably Appeals & Grievances, Claims, or Quality).

Working Conditions and Physical Demands

Employee must be able to meet the following requirements with or without an accommodation.

This is a sedentary position in an office setting that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position involves sitting most of the time and is not exposed to adverse environmental conditions.

Physical Requirements

Listening, Sitting, Speaking

Multi-lingual Candidates Welcomed

To inquire about this posting, email: careers@hsc.utah.edu

EEO Statement

University of Utah Health Hospitals and Clinics, a part of The University of Utah, values candidates who have experience working in settings with students and patients from all backgrounds and possess a strong commitment to improving access to higher education and quality healthcare for historically underrepresented students and patient populations.

All qualified individuals are encouraged to apply. Veterans’ preference is extended to qualified applicants, upon request and consistent with University policy and Utah state law. Upon request, reasonable accommodations in the application process will be provided to individuals with disabilities.

University of Utah Health Hospitals and Clinics, a part of The University of Utah, is an Affirmative Action/Equal Opportunity employer and does not discriminate based upon race, ethnicity, color, religion, national origin, age, disability, sex, sexual orientation, gender, gender identity, gender expression, pregnancy, pregnancy-related conditions, genetic information, or protected veteran's status. The University does not discriminate on the basis of sex in the education program or activity that it operates, as required by Title IX and 34 CFR part 106. The requirement not to discriminate in education programs or activities extends to admission and employment. Inquiries about the application of Title IX and its regulations may be referred to the Title IX Coordinator, to the Department of Education, Office for Civil Rights, or both.

To request a reasonable accommodation for a disability, please contact the University of Utah Health Hospitals and Clinics Human Resources office at 801-581-6500. If you or someone you know has experienced discrimination or sexual misconduct including sexual harassment, you may contact the Director/Title IX Coordinator in the Office of Equal Opportunity (OEO). More information, including the Director/Title IX Coordinator's office address, electronic mail address, and telephone number can be located at: www.utah.edu/nondiscrimination/

Online reports may be submitted at eoe.utah.edu/

The University is a participating employer with Utah Retirement Systems (“URS”). Eligible new hires with prior URS service, may elect to enroll in URS if they make the election before they become eligible for retirement (usually the first day of work). Contact Hospitals and Clinics Human Resources at (801) 581-6500 for information. Individuals who previously retired and are receiving monthly retirement benefits from URS are subject to URS’ post-retirement rules and restrictions. Please contact Utah Retirement Systems at (801) 366-7770 or (800) 695-4877 or Hospitals and Clinics Human Resources at (801) 581-6500 if you have questions regarding the post-retirement rules.

This position may require the successful completion of a criminal background check and/or drug screen.

Requisition Number 83136

Reg/Temp Regular

Employment Type Full-Time

Shift Day

Work Schedule 8-5 monday - friday

Clinical/Non-Clinical Status Non-Clinical

Location Name University of Utah Health Plans

Workplace Set Up Remote

City Murray

State UT

Department UIP CST 01H Quality Improvement

Category Health Plans

Workplace Set Up Remote