Job ID: J122162
Company: Highmark Inc
Location: Pittsburgh, PA, United States
Full/Part Time: Full time
Job Type: Regular
Posted at: May 3, 2018
This job defines, plans, implements and successful delivers Individual/Small Group Market's Open Enrollment Process (OEP). Oversees and manages all activities necessary to maintain efficient business mitigation & control processes, while ensuring adherence to all applicable state and federal regulatory standards. Ensures assigned Strategic Initiatives are proactively and comprehensively managed; implementing the sales, marketing and product strategies reducing the risk of non-compliance and meeting or exceeding planned revenue. Acts as the primary Business Interface to Strategic Operations and IT towards strategic delivery. Promotes a risk aware culture; ensure effective risk & compliance management practices by adhering to required standards and processes. The incumbent is primarily responsible for representing Highmark Individual and Small Group Markets with HMHS and HPO for the identification of critical market operations issues, oversight for cross functional issue resolution, resource alignment, assurance for processes or capabilities definition based on business direction, and oversight that monitoring controls are institutionalized. Reports to the Vise President, Market Performance and Implementation within the Individual/Small Group Markets organization.
Provide wing-to-wing leadership for Open Enrollment process (OEP). Organize, direct and coordinate cross-functional activities to focus corporate resources on the successful delivery and implementation of the OEP while adhering to all state and federal laws and regulatory standards.
Assess risks that might jeopardize successful achievement of the desired results of OEP, develop risk mitigation strategies and tactics, and implement risk mitigation plans.
Participate and lead key Strategic Initiatives. Identification and justification of strategic projects that drive value and differentiation of Individual/Small Group Market products in the local and national markets to ensure they are planned and executed successfully. Participate in budgeting and budget adherence.
Monitor and evaluate the progress, alignment and financial "health" of assigned Strategic Initiatives. Direct corrective actions as needed to maintain the viability of assigned Initiatives. As required - Report to the executive team/sponsor/steering committee on the progress, business impacts and strategies around assigned Initiatives.
Manage daily direction of work processes and prioritization with assigned staff monitoring as necessary to ensure accurate & timely OEP readiness, Risk Mitigation and Strategic Initiatives Delivery. Ensure operational excellence relative to the OEP, Strategic Initiatives and related compliance activities.
Serve as the subject matter expert for OEP related work processes and systems. Provide subject matter guidance and leadership to internal Individual/Small Group Individual market's teams as well as matrix partners. Conduct and implement lessons learned to continuously improve the OEP and Initiatives delivery processes adapting to business needs.
Prioritize & resolve high impact potential problems collaboratively and effectively using strong judgment, thought leadership and critical thinking.
Other duties as assigned or requested.
LICENSES AND CERTIFICATIONS
Language (Other than English)
0% - 25%
PHYSICAL. MENTAL DEMANDS and WORKING CONDITIONS
Teaches/trains others regularly
Travel regularly from the office to various work sites or from site-to-site
Does Not Apply
Works primarily out-of-the office selling products/services (sales employees)
Does Not Apply
Physical work site required
Lifting: up to 10 pounds
Lifting: 10 to 25 pounds
Lifting: 25 to 50 pounds
Does Not Apply
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
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
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