HealthHelp - A WNS Company (www.HealthHelp.com), is the leader in the field of healthcare utilization & care management. We have gained this position by actively working to change out-of-date practices with a collaborative, non-denial based approach. Our methodology helps payors achieve a higher return on investment, gives providers education programs that better inform physicians, and ensures quality and safety for the patients needing treatment.

HealthHelp’s innovative approach and strong IT capability in specialty benefits management means that staff will move healthcare forward when provided with evidence-based solutions and second opinions. HealthHelp's staff is comprised of healthcare professionals who make a difference every day. HealthHelp has a desire to fill their company with talented and innovative people who want a career path filled with success and personal growth.

Our specialty benefits management services are broad and include, Cardiology, Oncology, Radiology, Radiation Therapy, Sleep Care, and Musculoskeletal Care. HealthHelp has two locations in Houston, one a corporate office and the second a state-of-the art contact center. HealthHelp is also proud to have another such contact center in Albany, New York.

WNS Global Services Inc. (NYSE: WNS) is a global Business Process Management (BPM) leader. WNS offers business value to 400+global clients by combining operational excellence with deep domain expertise in key industry verticals, including Banking and Financial Services, Consulting and Professional Services, Healthcare, Insurance, Manufacturing, Retail and Consumer Packaged Goods, Shipping and Logistics, Telecommunications, Travel and Utilities. Globally, the group’s over 44,000+ Professionals serve across 60 delivery centers in 16 countries worldwide.

Major Responsibilities

• Conducts training for Clinical Review staff pertaining to Utilization Review process, clinical rule rets, client/module/modality-specific workflows, and software enhancements
• Partners with Workforce Planning to develop training schedules conducive to achieving desired program specific outcomes
• Proactively identifies targeted improvement opportunities amongst new hires
• Partners with Human Resources and Clinical Operations leaders to highlight possible concerns amongst new hire staff
• Conducts focused training to ensure that all Clinical Review staff members are properly educated on HealthHelp policies and clinical processes
• Reviews monthly quality audit findings and conducts one-on-one coaching with Clinical Review staff to assist with resolving issues related to education and adherence to process and/or client-specific directives
• Leverages tools and methodologies to assess the effectiveness of educational content and delivery
• Advises Clinical Review management of opportunities for individual performance improvement via the Domestic Nurse Audit Tally
• Reviews the Daily Nurse Management Reports from the Quality Department to identify training opportunities

• Serves as first line of contact for Clinical Review staff to answer questions/provide clarification related to criteria, policy, and process
• Partners with Products to develop training material designed to promote process efficiency and desired program-specific outcomes
• Recognizes and informs management of process/performance gaps
• Adheres to all regulatory requirements and complies with HealthHelp policies and procedures
• Upholds professional standards and performs all work in a manner respectful of others
• Provides a high level of service and support to both internal and external clients
• Promotes business focus which demonstrates an understanding of the company’s vision, mission, and strategy
• Performs other duties as assigned to meet business needs

• Excellent listening, oral, and written communication/presentation skills
• Ability to communicate complex information in a clear and concise manner
• Strong problem solving, interpersonal, and customer service skills in both face-to-face and remote settings
• Ability to work on multiple projects simultaneously and prioritize work to meet adapting deadlines
• Ability to recognize potential and actual problems and work effectively within a team to develop appropriate solutions and implement effective action plans to address the problems
• Demonstrated knowledge and experience in using critical thinking skills
• Proficient with Microsoft Office Suite and Windows
• Proficient with setting up webinars and multi-participate conference calls