Manager of Benefit Plan Configuration - Health Insurance Plans

Manager of Benefit Plan Configuration - Health Insurance Plans

(Benefits Plan Design)

We are seeking a Manager of Benefit Plan Configuration, who is very experienced with designing and building Health Insurance Plans specific to each Customer.

The ideal candidate will be highly motivated, passionate, and organized with experience in Plan design and Plan build and very familiar with the technology that supports claims adjudication.

The Manager will be responsible for overseeing and providing leadership for accurate, compliant, efficient configuration to support all lines of the Business that is offered to our clients through our organization.

The Manager will have an in-depth knowledge and understanding of Claim Processing as well as current coding, mapping, and configuration trends.

You’ll leverage this knowledge and be an integral part in helping to create the vision and strategy for process improvement while helping increase our automation results.

This is a full time, permanent opportunity reporting to the VP of Operations.

Specific Job Responsibilities:

* Provide leadership and accountability for managing the day- to-day operations of the Plan Build team.

* Drive team performance through audits, coaching, and development.

* Direct team to resolve business problems through collaboration.

* Establish Plan Build policies and procedures that will enhance productivity while increasing automation.

* Communicate configuration requirements, track and report on progress, to ensure KPI’s are met.

* Develop goals, objectives, and KPI’s at the team/associate level and be accountable for achieving results.

* Solid ability to identify problems and implement solutions.

* Operate with a sense of urgency and a focus on quality, efficiency, and customer service.

* Participate in performance reviews, recruitment, and dismissal.

* Perform other related duties and projects as assigned.

We are an Affirmative Action - Equal Opportunity Employer (Minorities / Females / Vets / Disabled). We provide equal opportunities to all employees and applicants for employment without regard to sex, race, color, religion, marital status, national origin, age, genetic information, sexual orientation, gender (including gender identity/expression), disability, veteran status and military status, pregnancy or pregnancy-related medical co

Covid-19 - We ask that you are fully vaccinated for Covid-19.

We value our employees and look forward to hearing from you.

* Bachelor’s degree or five (5+) years equivalent experience in Benefits Configuration and Design.

* Three (3+) years of management experience.

* Experience working in a Third-Party Administration (TPA) environment is preferred.

* Experience with WLT software for claims adjudication is desired.

* In depth knowledge of medical billing, coding, and plan design.

* Demonstrated leadership through best practices, methodologies, and tools to lead the configurations activities across multiple products.

* Ability to provide strategic leadership to design future state of Plan Build.

* Experience developing and executing test plans.

* Extensive experience understanding how medical coding relates to plan build, data maintenance, and reimbursement methodologies.

* Excellent interpersonal, oral and written communication skills.

* Strong attention to detail and organization.

* Ability to multi-task, problem solve effectively, prioritize, and follow-up.

* Ability to understand, articulate what is needed, and use data to drive decisions.

* Ability to work comfortably in a fast-paced environment.

* Excellent people manager with track record of growing and developing teams.