Manager Group Implementation and Funding Management Business Support

Description

JOB SUMMARY

This job is responsible for the strategic implementation of new or transitioned accounts while managing a team of professionals.

The scope of responsibility may include; Administrative Services Only (ASO); TPA services with an expanded BCI / HNAS offering and management of claims funding and cash management.

While identifying and driving process improvements across the entire HNAS Business Support and Group Implementation operation, the incumbent actively participates in projects and activities that impact the Sales and Operations and claims finance business unit functions.

ESSENTIAL RESPONSIBILITIES

• Perform management responsibilities to include, but are not limited to : involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.
• Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary;

may have budgetary responsibility and authority.

• Manage the performance of dedicated Implementation Coordinators charged with managing and implementing key accounts including new groups and key renewals.
• Act as a liaison for group changes (as specified in the summary section) between Information Technology, Account Operations, Billing & Enrollment, Group Configuration, Vendor areas, QA, and Account Management by directing, coordinating, and completing key tasks to ensure timely and accurate results.

Tasks may include coordination of internal Group Implementation meetings, development of project plans and status reports, oversight of New Sale and Renewal tasks and identification of potential issues.

• Participate in process improvement initiatives aimed at improving the group / broker customer experience initiative. Actively support and roll out technology initiatives aimed at improving the group / broker customer experience initiative.
• Manage claim funding billing process and collection, clearly identifying management status of accounts.
• Responsible for coordination and development of IT requirements, validation of data and output, and regular interaction with Communications and Fulfillment to ensure timely and accurate mailings.
• Support Management and staff by resolving group / broker questions and escalated issues.
• Lead and conduct staff meetings, and attend cross-functional business unit and corporate team meetings.
• Perform other duties as assigned or requested.

EXPERIENCE

Required

• 5 years of relevant work experience in the health insurance industry
• 3 years in a management or leadership role

Preferred

Experience in a range of operational settings in the health insurance industry (e.g., customer service, claims, business support)

EDUCATION

Required

Bachelor's degree or relevant experience and / or education as determined by the company in lieu of bachelor's degree

Preferred

None

LICENSES or CERTIFICATIONS

Required

None

Preferred

• Project Management Certification
• Six Sigma Certification

SKILLS

• Strategic thinking / planning skills
• Excellent time management & organizational skills with a strong attention to detail
• Excellent verbal and communication skills
• Strong analytical skills with the ability to implement effective solutions with a short term and long term focus
• Demonstrated coaching and staff development skills
• Project management skills
• Must be able to work in a fast-paced environment and be able to multi task with daily work processing deadlines
• High energy level and ability to project enthusiasm
• Persuasive communication style
• Ability to understand all customer needs (group, broker, provider, etc..) and the interconnection of all core and ancillary systems
• Microsoft Word, Excel, PowerPoint, Access Intermediate

Language (Other than English) :

None

Travel Requirement : 0% - 25%

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products / services (sales employees)

Never

Physical work site required

Lifting : up to 10 pounds

Constantly

Lifting : 10 to 25 pounds

Occasionally

Lifting : 25 to 50 pounds

Rarely

Pay Range Minimum : $67,500.00

$67,500.00

Pay Range Maximum : $124,800.00

$124,800.00

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation / gender identity or any other category protected by applicable federal, state or local law.

Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation / gender identity, protected veteran status or disability.

EEO is The Law

Equal Opportunity Employer Minorities / Women / Protected Veterans / Disabled / Sexual Orientation / Gender Identity ()

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