Job Details

Job Title

Company: Highmark Inc. Job 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. HNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization with a mission to create remarkable health experiences. Our culture is built on your growth and development, collaborating across our organization, and making a big impact for those we serve This role is looking for someone who has leadership experience along with experience with TPA, Stop loss, and self-funded clients.

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

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 Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

Pay Range Minimum: $67,500.00 Pay Range Maximum: $126,000.00 Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

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 any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ...@highmarkhealth.org.