NOA Template Monitoring and Oversight Specialist

Summary

The Approval Template Specialist’s primary responsibility is to prepare, associate, and upload all letter templates according to line of business, upon receiving the most current, updated or appropriate templates from the health plans. In addition, monitoring of all templates currently in use.

The NOA Approval Template Specialist reports directly to the Supervisor, NOA Team/BA Team under the guidance of the Vice President of Medical Affairs.


Duties and Responsibilities

  • Verify that all letter templates have the mandated languages for each of line of business, the appropriate/needed NDN and language inserts.
    • Contact the health plan if further information is needed or if there are questions that need answering.
  • Correct any style or formatting in order for this information to be pulled through sPHERICAL. (appropriate font, bold, italics, etc.)
  • Submit appropriate created tags for each letter.
  • Test letter template for each line of business and all languages.
    • This testing will be under the guidance of the sPHERICAL BA Team.
  • Upload and associate template in sPHERICAL notating the date of implementation with a note stating reason for new letter template or updates.
  • Send all template letter examples to Compliance Officer and/or Compliance UM.
  • Logging via Smartsheet all template requests, updating, testing and implementation dates.
  • Weekly monitoring of processed approvals to ensure correct templates were used and format is correct.

Minimum Job Requirements

  • High school diploma or GED equivalent.
  • Knowledge of medical terminology.
  • Knowledge of NCQA Standards, DMHC, DHCS, and CMS regulatory requirements.
  • Advanced proficiency in Microsoft Word

Skills and Abilities

  • Strong organizational and task prioritization.
  • Ability to multi-task while remaining adaptable and flexible to fast-paced environment.
  • Ability to keep up with constant changes as needed from the health plan.

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