The Director or VP of Federal Employee Program directs and leads the Cambia Federal Employee Program (FEP), including customer service, claims processing, member education and issue resolution, general correspondence, business technical support, PIP outcomes and provider services. Also responsible for FEP sales and marketing activities and development of annual business plans. The position works closely with internal and external departments and stakeholders to ensure FEP activities are supported and objectives achieved. The selected FEP leader will have the opportunity to spearhead strategy on modernizing the FEP business and lead a $1B revenue business.
General Functions and Outcomes:
- Plans and directs all operational activities for Federal Employee Program Personnel.
- Responsible for the activities performed by FEP management to assure performance goals are met, including productivity, accuracy, timeliness and quality of service to our members, business partners and Director's office.
- Works collaboratively with leaders and teams across the organization, including marketing, medical management, sales, pharmacy, quality, provider services and IT.
- Directs the establishment, maintenance, improvement and monitoring of the performance of FEP operational functions.
- Provides strong leadership to employees by facilitating and making timely decisions, providing effective communication and helping motivate leadership throughout FEP.
- Provides input to major corporate operating decisions and policies, concentrating on their impact upon the effectiveness of the FEP program.
- Develops, reviews and recommends objectives and develops policies to meet current and future needs of the division. This includes maintaining performance within the approved budget and continually striving for distinction in our markets based on quality of our customer interactions, and developing the yearly strategic plan.
- Assists in the strategic planning and development of the FEP function throughout Cambia, working jointly with executives and local management teams at Affiliates to coordinate local issues.
- Directs the development, implementation and reporting for FEP claims, customer service and system technical support (Cambia wide) for dedicated FEP Shared Systems.
- Acts as the corporations primary liaison on the FEP contract with the FEP Director's Office, FEP Operations Center, government agencies, providers and customers.
- Oversees employee selection criteria and implementation of tools necessary to exceed the expectation of our customers.
- Conducts business with high regard for Cambia's corporate values and in compliance with its Code of Business Conduct.
- Directs FEP Marketing activities and forecasts membership to ensure accurate staff and resources forecasting activities.
- Responsible for the creating and management of Federal Employee Program operating budget, ensuring achievement of budgetary targets.
- Proven ability to analyze and evaluate operational trends and interpret customer feedback to develop and implement improvements to business processes.
- Demonstrated ability to establish and maintain effective relationships with key internal and external stakeholders.
- Solid knowledge of the health insurance industry including demonstrated experience working with Federal Employee Programs preferred.
- Demonstrated ability to create, execute and evaluate short and long-term operating plans, analyze statistical information and direct multiple teams with varied functions/responsibilities.
- Successful leadership of a high volume operations center including establishment of a high performance, customer-centric culture with a focus on service excellence.
- Excellent judgment, problem solving skills, analytical and cognitive.
- Strong project management experience, including the ability to partner across groups to ensure projects are resourced and supported.
- Excellent verbal and written communication skills. Ability to communicate effectively, both orally and in writing, with individuals and groups, regarding complex or sensitive issues or regulations.
Normally to be proficient in the competencies listed above:
Director or VP Federal Employee Program would have a Bachelor's Degree in Business Management and 7+ years of experience in healthcare operations/administration or equivalent combination of education and experience.