Manager Billing and Funding - HNAS

Highmark Health; Santa Fe (NM); On-site; USD 67,000 - 126,000; Full time

Job summary

A leading health organization in Santa Fe seeks a strategic implementation manager to oversee new account implementations and lead a team. This role demands strong leadership, 5 years in health insurance, and experience with TPA and self-funded clients. Competitive salary range is $67,500 – $126,000, based on qualifications. Join us to make a difference in health experiences.

Qualifications

• 5 years of relevant work experience in the health insurance industry.
• 3 years in a management or leadership role.
• Experience with TPA, Stop loss, and self-funded clients.

Responsibilities

• Perform management responsibilities including hiring and termination.
• Manage the performance of Implementation Coordinators.
• Act as a liaison for group changes across departments.
• Participate in process improvement initiatives.
• Manage claim funding billing process.
• Lead staff meetings and participate in cross-functional meetings.

Skills

Strategic thinking/planning

Excellent time management

Strong analytical skills

Coaching and staff development abilities

Project management skills

Persuasive communication style

Education

Bachelor's degree or relevant experience

Tools

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Microsoft Access

Job description

Overview

Highmark Inc. – Job Description

This role is responsible for the strategic implementation of new or transitioned accounts while managing a team of professionals. The scope may include Administrative Services Only (ASO); TPA services with an expanded BCI/HNAS offering and management of claims funding and cash management. The incumbent identifies and drives process improvements across the HNAS Business Support and Group Implementation operation and actively participates in projects and activities that impact the Sales and Operations and claims finance business unit functions. HNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization focused on delivering remarkable health experiences. Our culture emphasizes growth and development, collaboration, and making a big impact for those we serve.

This role looks for someone who has leadership experience along with experience with TPA, Stop loss, and self-funded clients.

Responsibilities

• Perform management responsibilities including hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control day-to-day operations; develop and implement policies and programs; may have budgetary responsibility and authority.
• Manage the performance of dedicated Implementation Coordinators responsible for managing and implementing key accounts including new groups and key renewals.
• Act as a liaison for group changes between Information Technology, Account Operations, Billing & Enrollment, Group Configuration, Vendor areas, QA, and Account Management; coordinate and complete key tasks to ensure timely and accurate results. This includes internal Group Implementation meetings, project plans, status reports, oversight of New Sale and Renewal tasks, and identification of potential issues.
• Participate in process improvement initiatives aimed at enhancing the group/broker customer experience; support and roll out technology initiatives to improve the group/broker customer experience.
• Manage claim funding billing process and collection, clearly identifying management status of accounts.
• Coordinate the development of IT requirements, data validation, and output, and interact with Communications and Fulfillment to ensure timely and accurate mailings.
• Support Management and staff by resolving group/broker questions and escalated issues.
• Lead and conduct staff meetings, and participate in cross-functional business unit and corporate team meetings.
• Perform other duties as assigned or requested.

Experience

Required

• 5 years of relevant work experience in the health insurance industry
• 3 years in a management or leadership role

Preferred

• Experience in a range of operational settings in the health insurance industry (e.g., customer service, claims, business support)

Education

Required

• Bachelor\'s degree or relevant experience and/or education as determined by the company in lieu of bachelor\'s degree

Preferred

• None

Licenses or Certifications

Required

• None

Preferred

• Project Management Certification
• Six Sigma Certification

Skills

• Strategic thinking/planning
• Excellent time management and organizational skills with strong attention to detail
• Excellent verbal and written communication skills
• Strong analytical skills with the ability to implement effective short- and long-term solutions
• Coaching and staff development abilities
• Project management skills
• Ability to work in a fast-paced environment and multi-task with daily processing deadlines
• High energy and ability to project enthusiasm
• Persuasive communication style
• Ability to understand customer needs (group, broker, provider, etc.) and interconnection of core and ancillary systems
• Microsoft Word, Excel, PowerPoint, Access – Intermediate

Other Information

• Language (Other than English): None
• Travel Requirement: 0% - 25%
• Physical, Mental Demands and Working Conditions
• Position Type Office-based
• Teaches / trains others regularly – Occasionally
• Travel regularly from the office to various work sites or site-to-site – Rarely
• Works primarily out-of-the office selling products/services (sales employees) – Never
• Physical work site required – Yes
• Lifting: up to 10 pounds – Constant
• Lifting: 10 to 25 pounds – Occasional
• Lifting: 25 to 50 pounds – Rarely

Disclaimer: The job description outlines the general nature and essential duties and responsibilities of work performed by employees within this title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required.

Compliance Requirement: This job adheres to ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to confidential information and must comply with HIPAA and company data security policies.

Additionally, employees must comply with the company\'s Code of Business Conduct and applicable laws, rules, and regulations, as well as company policies and training requirements.

Pay Range
$67,500.00 – $126,000.00

Base pay is determined by qualifications, experience, and other factors. The displayed salary range does not reflect geographic differentials Highmark may apply.

Highmark Health and its affiliates prohibit discrimination against qualified individuals and ensure accessibility of the site. For accommodation requests, contact HR Services at [e-mail]

California Consumer Privacy Act Notice

Req ID: J270493