Manager, Select Accounts-TPA/Taft Hartley

Job ID: J125086
Company: Highmark Inc
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at: Jun 15, 2018

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Description

Manage the corporate large clients end to end delivery system for various National Accounts and Regional Accounts which includes the following:
•    Direct management oversight and responsibility for customer service, claim administration, billing for unique clients, achievement of operational performance guarantees, procedures and functions
•    Responsible for the management and execution of the Customer Care Advocacy (CCA) service delivery and working collaborative with the Health Management Solutions clinical team to achieve key performance measures of the model
•    Manage people to produce high quality work output and throughput and be able to select, develop, and continuously coach staff to the highest levels of performance
•    Serves as the client/sales lead/interface for all of the Operational Delivery verticals.
•    Serves as a Subject Matter Expert/Consultant for Health Solutions project managers for claims and service related functions when implementing new Blues plans on the Highmark platform.
•    Attends client facing meetings to discuss operational performance.
•    Represents Highmark customer service for client final presentations when requested.
•    Assists the sales and external facing team in answering detailed questions for Request For Proposal (RFP) questionnaires for Select Accounts New To Blue clients or existing clients.

*This person must come with Taft Hartley experience and/or TPA experience.

**This person will be expected to travel 25-50% of the time initially.

***Employee Referral Payout Level: 1

Essential Responsibilities:

  • Motivate and team build through the creation of a work environment and conditions that contribute to highest levels of performance including establishing effective working relations, elimination of distraction, the promotion of fairness and equality, modeling correct behavior, and rewarding and recognizing high performance and goal completion. Constant communication with peers, clients, customers, other Operational and HPO verticals are critical.
  • Fully utilize the support mechanisms available to complete the required delivery of high performance, low cost production. Strong relationship and collaboration with many areas throughout  Highmark is an area of focus for the manager, both as an individual and for their entire team. This includes but is not limited, other Operations verticals, the Command Center, the Competency Centers, Operations Solutions, Finance, Provider Relations, Sales Product and Development, Consumerism, etc.
  • The Manager supports strategic planning under the direction of senior leadership.  Decision-making authority is inter-team, and cross-departmental and the Manager collaboratively guides problem solving within the functional area working with support units and other Managers, under the guidance of senior leadership.
  • The Manager is accountable for Client relationships and is the point of contact for external entities, such as other functional management, non-HPO departments, BCBSA, etc. as directed by senior leadership.
  • Responsible for providing the necessity input to develop and maintain capacity plans and staffing models that comply with budget.  Effective collaboration required in working with other HPO claim and service directors.
  • Participates in all forms and frequencies of client-facing meetings, implementation meetings, and final presentations for new or existing business.  Travel is performed as needed to meet with groups or attend client/consultant conferences.

MINIMUM QUALIFICATIONS

  • High School Diploma or GED
  • 5-10 years’ experience in an claims and customer service operations

Preferred

  • Taft Hartley and/or Third Party Administration experience
  • Bachelor's Degree Business

KNOWLEDGE, SKILLS and ABILITIES

  • Knowledge of corporate control functions, particularly as applied to all HPO Operations                                
  • Proficiency in a variety of Microsoft Office products                       
  • Ability to quickly identify and provide recommendations to resolve issues                           
  • Strong organizational and time management skills with the ability to multitask and quickly reprioritize    
  • Experience in team building, facilitation, negotiation, and conflict resolution                       
  • Effective decision making to approve and maintain Highmark Employee Account access

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/ProtectedVeterans/Disabled/Sexual Orientation/Gender Identity (http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf)
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please call HR Services at 844-242-HR4U or visit HR Services Online at HRServices@highmarkhealth.org

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