Job Summary:
Oversees fully insured and self-funded group installation processes across multiple regions and multiple functional areas. Monitors installation activities for new and renewing national and regional groups, and will actively manage tasks, processes and time lines always keeping the customer at the forefront. Partners with sales and account management to support the customer through the installation process and to positively impact the customer experience. Resolves issues during the installation process and/or escalate potential issues to department Managers, National Leads or National Directors. May be responsible for creating and distributing installation plans, reports, summaries and hand-off documentation. May be responsible for supporting project initiatives, gap analysis, implementing lessons learned, training and mentoring of new staff. May be responsible for looking for opportunities for process improvement and influence change.

Essential Responsibilities:

Case Installation:

Manage the overall installation of new and approved renewing accounts (mainly standard and some complex).

Function as a main point of contact for the customer during the account installation.

Partner with Sales and Account Management, Regional Case Installation Teams, Regional Functional Areas (e.g. CSC, Membership Administration, Benefits, Contracts) to ensure a successful account installation.

Coordinate tasks and maintain installation time lines across multiple regions and multiple functional areas, working with department Directors and Managers.

Ensure functional departments understand and comply with established processing and customer commitment dates.

Create installation checklists, time lines and plans and communicate to the customer.

Track all installation activities using a reportable database and monitor those activities to identify potential risks or known issues. Use database to report on group-specific activities or summary statistics.

Resolve issues during the installation and renewal processes, working directly with regional contacts and functional departments to ensure installations comply with standard processes guidelines.

Monitor the reconciliation of application, enrollment and fulfillment processes such as ID cards, Member Handbooks, EOC and Provider Directories. Resolve or escalate inconsistencies identified.

Coordinate Installation meetings with National Sales, Account Management, Brokers and/or Employer Groups.

Facilitate seamless hand-off to National Account Management staff, supported by group-specific reporting metrics, issue review and installation processing summary.

Relationships:

Develop strong cross functional relationships to partner and support Sales and Account Management and to ensure that the National Case Installation process is used.

Provide leadership to cross functional regional work teams in establishing approach to support national, multiregional and total replacement accounts.

The incumbent routinely interacts with Customers, National Sales and Account Management, National and Regional Partners, Provider Relations, Provider Contracting, and Claims Managers, KPIT Managers, SFAS Staff, Third Party Claims Administrator, and other outside vendors.

Basic Qualifications: Experience

Minimum five (5) years account services, case installation/implementation, project/program management, operations and/or relevant experience in a directly related field required.

Education

Bachelors degree in business administration, Health Care Administration or a related field, OR four (4) years of experience in a directly related field.
High School Diploma or General Education Development (GED) required.

License, Certification, Registration

Additional Requirements:

Working knowledge of Self-Funding and Fully Insured Healthplans.
Understanding of healthcare insurance products and processing.
Ability to educate and influence complex, cross-functional business partners on Self-Funded products and administration.
Ability to define, develop, document and implement formal Policies and Procedures related to Self-Funded products and services.
Thorough understanding of and experience in managed care and all health insurance products, including self-funded.
Knowledge of the health insurance market.
Knowledge of Commercial and/or Self-Funded billing requirements and claims adjudication practices.
Broad knowledge of health plan administration and operational needs for Self-Funded products.
Strong interpersonal skills, especially specific to persuasion and negotiation.
Demonstrated ability in influence operational management.
Demonstrated ability to determine the key risks that need to be addressed and develop actions plans that are multi-faceted in nature and include both business process.

Preferred Qualifications:

Preferred more than five (5) years account services, case installation/ implementation, operations and/or relevant experience within the health insurance industry, including project/program management experience, with successive levels of accountability and results.