Mgr Contract Administr Ops
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Job Summary
This Position Is Responsible For Managing The Unit Responsible For The Production Of Customer-Specific Documents For New/Existing Business In Accordance With Corporate Guidelines, Underwriting Policy, Benefit Specifications, And Statutory Requirements. Manages The Performance, Overall Quality And Resource Allocation To Support All Product Lines, Including Key Sales Support Components Of Benefit Selection Through Booklet Delivery. Oversee The Creation And Maintenance Of Standard And Custom Booklets. Implements Strategies, Projects And Initiatives.1. Manages the personnel and unit(s) of The Enterprise Contract Administration department which is responsible for drafting, vetting and filing all group and retail member and employer documents (and some government documents) including all Exchange Affected Markets. Manages all aspects of employer contract negotiations; including tracking signatures and custom provisions. Maintains all documents, version control and makes updates as required.
2. Provide subject matter expertise relating to both employer and member documents (e.g., certificate booklets, ASAs, BPAs, etc).
3. Manage all updates to member and employer masters. Ensure documents are updated to comply with policies, regulations, and Blue Card language.
4. Oversee creation and historical maintenance of standard and custom certificate language in accordance with the local Department of Insurance according to statutory requirements, and with internal HCSC policies and guidelines.
5. As a people manager responsibilities include but are not limited to: hiring, budget, training, performance management, pay administration, change management, succession planning if needed, talent management, and maintain knowledge of corporate, department and Human Resources programs, policies and systems.
6. Act as project leader on special projects and legislative task forces.
7. Prepare and communicate routine performance management reports and issue resolution.
8. Manages staff including but not limited to: hiring, training, performance management, pay administration, budget, change management, and maintain knowledge of corporate and Human Resources policies, programs and systems.
9. Ensure deviations from policies, procedures, and guidelines are reviewed and approved.
10. Assist as needed in preparation of responses to Department of Insurance or legal inquiries involving specific accounts.
11. Communicate and interact effectively and professionally with co-workers, management, customers, etc.
12. Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
13. Maintain complete confidentiality of company business.
14. Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.
JOB REQUIREMENTS:
* Bachelor's degree and 5 years of health insurance contract operations experience PLUS one year of management experience OR 9 years of health insurance contract operations experience PLUS one year of management experience.
* Knowledge of health products and procedures, underwriting requirements, contract and funding arrangements.
* Analytical and reporting skills.
* PC proficiency to include Microsoft Office Suite.
* Project management skills.
* Customer service experience and acumen.
* Leadership skills.
* Verbal and written communications skills to manage staff and operations, build relationships across the organization and with external key stakeholders, build consensus and issue resolution.
PREFERRED REQUIREMENTS:
* J. D. degree or 4 years experience in a leadership role with independent decision-making.
* Knowledge of external adjudication processes.
* Knowledge of large or national account contract specifications and processing systems.
* Knowledge of corporate marketing practices, health insurance product lines and Par Plan operations.
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
Pay Transparency Statement:
At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.
The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plansubject to the terms and the conditions of the plan.
HCSC Employment Statement:
We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
Base Pay Range
$92,700.00 - $167,500.00Exact compensation may vary based on skills, experience, and location.