Founded in 1978, Universal Health Services, Inc. (UHS)* is one of the nation's largest and most respected healthcare management companies, operating through its subsidiaries-acute care hospitals, behavioral health facilities and ambulatory centers nationwide. With more than 74,000 people employed by UHS subsidiaries, UHS's business strategy is to continue to grow by building or purchasing healthcare facilities across the country, while continuing to strengthen UHS's well-reputed franchise with its customary exceptional service and effective cost control. Our success is driven by a service philosophy based on integrity, competence, compassion, and a responsive management style. UHS has been recognized as a Fortune 500 company and is listed as one of Fortune's Most Admired Companies. UHS's Acute Care Division is comprised of 25 high performing hospitals and several ambulatory care facilities across the nation and prides itself on providing superior patient care.
Prominence Health Plan, established in Reno in 1993 as St. Mary's Health Plan, was acquired in 2014 by Universal Health Services (UHS), one of Fortune Most Admired Companies.
In addition to the HMO, Prominence Health Plan also offers Point of Service health plans, a preferred health insurance company that offers Preferred Provider Organization (PPO) health plans, and CDS Group Health, a third-party administrator.
We are a fast-growing, rapidly-changing healthcare organization offering the excitement of a start-up with the support of a Fortune 500 company. We are looking for talented, enthusiastic people to help shape the future of our organization.
Job Summary: The Resolution Specialist acts as a liaison between members, providers, claims, enrollment, pharmacy and customer service departments. The Resolution Specialist supports the Manager of Operations and other departments to ensure accuracy, quality, and integrity services is being delivered to our members. Responsibilities will also include ensuring high performance levels for department, resolve escalated issues, assigned special projects, developing quality, compliance tracking tools, modifying processes, policies and procedures to achieve and maintain consistent compliance with Federal, State, and accrediting regulations and standards.