Account Manager - Pool

TX Health Benefits Pool; United States; Remote; USD 50,000 - 70,000; Full time

Benefits offered by this job

Flexible work arrangements

Travel opportunities within Texas

Job summary

A health benefits organization is seeking an Account Manager to enhance member satisfaction and support Benefit Coordinators. The role involves resolving service issues, maintaining relationships, and ensuring timely implementations. Candidates should have experience with healthcare plans, exceptional customer service skills, and proficiency in Salesforce. Work arrangements are flexible with remote capabilities during the week, requiring occasional onsite presence as needed.

Qualifications

• 1 year experience with healthcare plans and underwriting.
• Understanding of compliance regulations like COBRA and HIPAA.
• Strong communication skills for member interaction.

Responsibilities

• Develop positive relationships with Benefit Coordinators.
• Ensure prompt resolution of service issues.
• Document all interactions with Member groups.

Skills

Customer Service

Salesforce proficiency

Data analysis

Organizational skills

Leadership

Education

Bachelor’s degree or equivalent experience

Tools

Salesforce

Microsoft Office

Job description

Overview

The Account Manager is the primary Marketing contact supporting Benefit Coordinators with their service and support needs with the goal of achieving high member satisfaction, engagement and retention. The Account Manager will provide friendly, knowledgeable and effective service, coordinating with internal departments and external vendors as necessary to resolve any issues that the Benefit Coordinator reports. The Account Manager will develop and maintain positive relationships with our members and coordinate with the Account Executive to proactively identify and address member needs. The Account Manager will support the Account Executive with planning, preparation, and support of pre-renewal strategic discussions, renewal documentation, open enrollment meetings and overall service metrics.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Develop and maintain a positive working relationship with Benefit Coordinators of assigned groups. Establishes and maintains a high level of trust and confidence with groups, their employees and respective brokers / consultants.
• Ensure prompt response to service issues reported by Benefit Coordinators and facilitate resolution of issues by coordinating with internal departments and external vendors as necessary.
• Maintains daily and accurate documentation in appropriate systems (Salesforce, Member Database, etc.). Document all interactions with Member groups in Salesforce or other systems as appropriate. Ensure that cases are set up on a timely basis, referred to the appropriate party, and tracked throughout the process for resolution.
• Develop and maintain strong working relationships with the Marketing Account Management Manager, your assigned Account Executive, other internal Leaders, and various Departments within TX Health Benefits Pool.
• Coordinate and assist with onboarding of new member groups and assure accurate and timely implementation. This includes clear, concise, and consistent communication with new groups to gather all TXHB required documentation per established timelines. Examples: Business Acceptance Form, Enrollment Form, and Eligibility documents.
• Works closely with the Account Executive throughout the existing group renewal process, ensuring renewal paperwork is accurate, timely, and complete per established timelines.
• Communicate with new and existing groups regarding outstanding renewal, enrollment documents, audit documents, and outstanding invoice balance per established timelines.
• Provides competitive analysis and market vulnerabilities feedback from Member Groups and Broker/Consultants to the Account Executive, Sales Executive and Marketing Manager for assigned groups.
• May provide support and education on TX Health Benefits Pool strategy to new Benefit Coordinators and Decision Makers as well as new Broker/Consultants when there is a new Member Group Onboarding or when there is a change in contact for a current Member Group.
• May assist with administrative duties related to Enrollment and Billing as necessary. May include working basic Enrollment and Billing related work in TXHB Online.
• Assist the Account Executive or perform in-person strategic semi-annual, and pre-renewal reviews as needed. In addition, may also perform in-person or virtual meetings regarding TXHB programs and services as needed.
• Assist the Account Executive with proactive education and dialogue with Benefit Coordinators to ensure appropriate and timely decisions related to benefits and services.
• Promotes webinar education, Benefit Coordinator training, wellness events, and regional meetings to encourage attendance/participation.
• Work in cooperation with Account Executive to create, edit, and share targeted group reporting packages and presentation slide decks for open enrollment, strategic meetings, and other group meetings as assigned.
• Protects the confidentiality, integrity and availability of information and records that TX Health Benefits Pool creates, receives, maintains, or transmits by complying with TX Health Benefits Pool policies and procedures, including policies and procedures on physical, administrative, and technical safeguards.
• Physical safeguards are physical measures, policies and procedures that protect TX Health Benefits Pool buildings, equipment, and information systems from natural and environmental hazards and from unauthorized intrusion.
• Administrative safeguards are administrative actions, policies, and procedures that: manage TX Health Benefits Pool’s selection, development, implementation, and maintenance of measures that protect TX Health Benefits Pool’s information and records; and manage the conduct of TX Health Benefits Pool employees in protecting the privacy and security of TX Health Benefits Pool’s information and records.
• Technical safeguards are the technology and policies and procedures for its use that protect electronic information and records and that control access to electronic information and records.
• Assist with new projects and other duties as assigned in the department.

KNOWLEDGE/SKILLS/ABILITIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Ability to analyze and interpret claims data and reporting.
• Ability to facilitate collaborative teamwork, with supportive leadership and mentoring skills.
• Detailed oriented with a focus on exceptional Customer Service.
• Strong organizational skills, ability to manage multiple priorities and strong follow-through.
• Must be able to travel as needed, including overnight stays within Texas as necessary, to meet face-to-face with groups. (Expected travel 1-2 times per month)
• Full proficiency in the use of Salesforce, Microsoft Office suite (Word, Excel, PowerPoint, etc.)
• Technical ability to utilize TXHB online to make updates to data within the administrative guidelines.
• Working knowledge of current underwriting procedures for financing arrangements and benefit structures including and not limited to PPO, HMO, and HDHPs for fully insured groups.
• Thorough understanding of all TXHB benefits and services, and administrative guide, including medical benefits, pharmacy benefits, surgery benefits, vision benefits, dental benefits, spending accounts and Consumer Directed Health (CDH) plans.
• Practical knowledge of relevant laws and compliance regulations, including COBRA, HIPAA, handling Personal Health Information (PHI), etc.

EDUCATION/EXPERIENCE

Required

• 1 year experience working with a variety of healthcare plans and administrative services with familiarity of general healthcare underwriting process for fully insured group health plans.

Preferred

• 2-3 years’ successful experience in sales, account management, benefit services, or benefit plan management for fully insured health benefits and/or insurance products.
• Bachelor’s degree or 3-years of equivalent healthcare/benefits/insurance environment experience, or combination thereof for self-insured and fully insured groups.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Ability to speak/hear clearly to communicate by phone or in person.
• Ability to frequently stand, sit and walk.
• Ability to frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds.
• Ability to travel on a regular basis (1-2 times/month).
• Valid Texas driver’s license with acceptable driving history and ability to drive.

Flexible Work Arrangements

100% Remote - onsite as required (MON– FRI)