Lead Client Implementation Analyst

3 weeks ago

Philadelphia, United States Blue Cross and Blue Shield Association Full time

Our organization is looking for dynamic individuals who love to learn, thrive on innovation, and are open to exploring new ways to achieve our goals. If this describes you, we want to speak with you. You can help us achieve our vision to lead nationally in innovating equitable whole-person health.

The role of the Lead Client Implementation Analyst is responsible for the following job duties:

1. Provide training to new hires of the Client Setup department, as well as any key stakeholders

2. Track and review work inventory at the team level for timely and accurate completion

3. Set up all new business, benefit and administrative changes and cancellations when needed

4. Ability to recognize Underwriting guideline differences for PA vs. NJ

5. Organize reference materials and ensures written processes and procedures are being followed

6. Responds to high priority internal and external customer inquiries and issues surrounding customer set-up.

7. Provide guidance to team members on complex cases.

8. Track ongoing customer issues and recommend improvements to enhance customer relationship and corporate image

9. May participate in on-site visits to new employer groups and administrators to explain the set up process, educate on system capabilities and confirm compliance with underwriting guidelines

10. Resolve issues, answer questions and act as liaison with other departments on most complex client setup issues

11. Acts as consultant to Sales on form submission and accuracy

12. Knowledge of benefit template format and language

13. Coach and train client implementation specialists on benefit template accuracy

14. Provide reports to management regarding training needs, the customer/group set-up process and administrative processes

15. Provide technical assistance and guidance to Sales and other areas relative to the new business enrollment process

16. Conduct system testing as needed

17. Subject matter expert for business requirements

18. Research and troubleshoot benefits and any other issues

19. Perform additional duties as assigned

20. Serve as expert on group set-up including structure and system limitations

21. Represent the department in internal and external implementation meetings and other workgroups/meetings as needed

22. Identify discrepancies in systems and paperwork received from Sales; Ensure all requests meet Underwriting guidelines

23. Work closely with internal and external customers to resolve issues.

24. Understand renewal change requested by client, pull together set up documents including benefit templates

25. Confirm benefits on detailed benefit templates

26. Investigate and resolve complex client setup issues in core platform systems; such as FOS and CSIW

27. Investigate and resolve pharmacy setup issues, including complex clients. Resolve access to care for members in pharmacy benefit system

28. May develop new capabilities for the department in conjunction with other departments and vendors

A. High School Diploma required, bachelor's degree in business or related field preferred. Must have 5-7 years relevant experience.

B. Excellent time management and organizational skills required. Ability to prioritize workload and meet deadlines in a fast-paced environment with some supervision. Flexibility and adaptability are a must. Willingness to be cross trained is required to assist other team members. Strong communications skills required - position interacts with all levels of management and may communicate with external clients as well. Must be strong problem-solver and be able to follow-up and take an issue to resolution. Aptitude to understand benefits and Underwriting rating methodology. Some critical thinking skills: Capability to understand Underwriting guidelines and apply them. High level technical aptitude required - ability to use Microsoft Office and to learn proprietary and vendor systems. High level of professionalism is necessary to progress.

Hybrid

Independence has implemented a "Hybrid" model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the "Hybrid" model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania

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