Deliver a differentiated client experience to self-funded (ASC) and complex regional and national customers. Facilitate the flawless implementation of custom accounts inclusive of specialized benefits, enrollment files, and vendor files/extracts. Coordinate and provide multiple member integration touchpoints spanning traditional customer service, multi-channel member engagement, and high-touch medical management. Oversee the development of detailed project plans and support dedicated account executives in setting appropriate client expectations regarding claims and administrative billing, state mandates, stop loss, reporting, and other items that are unique to this financial arrangement/client. Integrate innovative wellness strategies and employer wellness programs. Coordinate ancillary and carve-out arrangements and corresponding data needs to mitigate member abrasion and maximize the experience of doing business with BCBSRI.
ESSENTIAL JOB FUNCTIONS:
- Deliver a differentiated client experience to self-funded (ASC) and complex regional and national customers.
- Serve as dedicated liaison between the client/consultant and internal teams to ensure overall client satisfaction. Propose and negotiate meaningful and acceptable solutions throughout the implementation process and beyond.
- Demonstrate a thorough understanding of all aspects of the ASC or complex client inclusive of stop loss, banking arrangements, ASO fees, broker commissions, etc., and a comprehensive understanding of downstream impacts of all client decisions to set appropriate expectations with the client/consultant.
- Oversee end-to-end initial implementation and annual renewals to encompass elements such as benefits, enrollment solutions, clinical integration, member and client contact center, web portal, mobile and retail solutions, and communication and open enrollmentsupport.
- Document and manage escalated concerns and operational issues to resolution, delivering thoughtful, client-oriented responses inclusive of contact center scripting/messaging.
- In collaboration with the client/consultant, facilitate the preparation of multi-channel open enrollment meetings and member education sessions in the form of product and benefit presentations, health fairs, and webinars, locally and nationally, as needed.
- Foster relationships with key human resource personnel, as well as with the broker/consultant community. Participate in client-sponsored groups and events.
- Provide on-site client education relative to web-based tools and resources, eligibility processing, and other topics deemed appropriate by the client.
- Remain current with the details of all products and services offered by the organization, as well as federal and state legislation impacting operations. Promote the products and messaging of the organization to the customer.
- Perform other duties as assigned.
Minimum Education and Experience:
- Bachelor's degree in Business Administration, Marketing, Finance, or related field; or an equivalent combination of education and experience.
- Five to seven years' experience managing employee benefits for large employer clients with a focus on healthcare.
- Experience in client management issue triage and resolution.
- Valid driver's license.
Preferred Education, Additional Qualifications, and Experience:
- Experience integrating large, multifaceted clients.
- Strategic focus.
Required Knowledge, Skills, and/or Abilities:
- Knowledge of commercial products and employee benefits packages.
- Knowledge of national healthcare trends, including healthcare reform legislation.
- Advanced analytical skills with the ability to interpret and synthesize complex data sets.
- Working knowledge of Microsoft Excel, PowerPoint, and Word.
- Good business acumen and political savvy.
- Knowledge of business process improvement techniques and strategies.
- Excellent verbal and written communication skills.
- Negotiation skills.
- Presentation skills.
- Decision-making skills.
- Good problem-solving skills.
- Ability to interface with employees at all levels.
- Ability to effectively navigate ambiguous situations with limited direction.
- Excellent organizational skills and ability to successfully prioritize multiple tasks.
- Ability to handle multiple priorities/projects.