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Adverse Action Adjudicator job in Nashville, TN

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Nashville, TN CorTech LLC

Job Ref:  375692
Employer:  CorTech LLC
Job Type:  Contract
Salary and Benefits:  35.00/Per Hour
Remote:  No

Location

City:  Nashville, TN
Post Code:  37203
Map: 

Description

JobsRUs.com is seeking to hire an Adverse Action Adjudicator for our client Nashville, TN!

Benefits Available!
Weekly Pay!

Pay Rate - $35/hr
1st Shift: Monday-Friday, 8am-5pm

Job Description
Considers derogatory information presented in a background investigation report and renders a decision on the basis of that information. Must be neutral, without conflict of interest, to determine fairly if a discrepancy between disclosed credentials and verified information is sufficient to disqualify a candidate for employment.

Major Responsibilities
· Review background investigation results to confirm a discrepancy with credentials exists that is not addressed by the adjudication matrix.
· Evaluate the disclosed discrepancy in a balanced way before making a decision.
· Interview background investigation vendor and/or the subject of the investigation if necessary to gain clarity.
· Make a decision based on knowledge of law, regulation, policy, precedent, and judgment of risk to employer to proceed with approval or deny approval.
· Periodically review for revision the adjudication matrix used by Recruiting.
· Create and maintain a record of adjudication decisions including justification for course of action.
· Create and maintain decision analytics for reporting.
· Keep all adjudication material confidential.
· Monitor business challenges and/or regulatory issues that might influence adjudication.
· Schedule and regularly meet with operations management and Human Resources Business Partners.
· Operates without supervision in a complex environment.
· Conduct investigations and recommend resolution in collaboration with Legal, Ethics and Compliance, Human Resources Business Partners and others as appropriate.
· Recommend process, product or service improvements.
· Solve unique and complex problems with a broad impact on the business.
· Computer and software literate

Required Education and Experience
Bachelor's degree in a related field.
1+ years of experience in a relevant field.

Knowledge, Skills, Abilities, and Behaviors
· Service and Quality Excellence: Ability to demonstrate an uncompromising commitment to delivering exceptional care to create an unmatched value proposition for our patients.
· Honor our Mission and Values: Ability to build trust and act with authenticity to cultivate a culture of integrity, inclusion, and mutual respect.
· Effective Decision Making: Ability to make timely, informed decisions that are in the best interest of our patients, employees, providers, and community.
· Attain and Leverage Strategic Relationships: Ability to develop and strengthen collaborative relationships with both internal and external stakeholders to advance the care of our patients and the growth of the company.
· Lead and Develop Others: Ability to lead others to accomplish organizational goals and objectives; provide meaningful coaching and mentoring to increase the capabilities of individuals and teams and drive employee engagement.
· Communicate with Impact: Ability to deliver information in a clear, concise, and compelling manner to effectively engage others and achieve desired results.
· Achieve Success through Change: Ability to identify opportunities for improvement and innovation, remove barriers and resistance, and enable desired behaviors.
· Drive Execution and Financial Results: Ability to commit to the success and financial wellbeing by challenging others to excel and hold themselves and others accountable · Strategic Positioner: Ability to position a business to win in its market.
· Credible Activist: Ability to build relationships of trust by having a proactive point of view.
· Paradox Navigator: Ability to manage tensions inherent in businesses (e.g., be both long and short term, be both top down and bottom up.)
· Culture and Change Champion: Ability to make change happen and manage organizational culture.
· Human Capital Curator: Ability to manage the flow of talent by developing Employees and leaders, driving individual performance, and building technical talent.
· Total Reward Steward: Ability to manage employee wellbeing through financial and nonfinancial rewards.
· Technology and Media Integrator: Ability to use technology and social media to drive/create high performing organizations.
· Analytics Designer and Interpreter: Ability to use analytics to improve decision making.
· Compliance Manger: Able to manage the processes related to compliance by following regulatory guidelines.
ref: (375692)
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