Business Operations Manager

1 day ago

Harrisburg, Pennsylvania, United States Highmark Health Full time
Job Summary

This role is responsible for the strategic implementation of new or transitioned accounts while managing a team of professionals. The scope of responsibility may include; Administrative Services Only (ASO); TPA services with an expanded BCI/HNAS offering and management of claims funding and cash management.

Key Responsibilities
  • Management Responsibilities
    • Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.
    • Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
  • Implementation and Management
    • Manage the performance of dedicated Implementation Coordinators charged with managing and implementing key accounts including new groups and key renewals.
    • Act as a liaison for group changes (as specified in the summary section) between Information Technology, Account Operations, Billing & Enrollment, Group Configuration, Vendor areas, QA, and Account Management by directing, coordinating, and completing key tasks to ensure timely and accurate results.
  • Process Improvement and Technology
    • Participate in process improvement initiatives aimed at improving the group/broker customer experience initiative.
    • Actively support and roll out technology initiatives aimed at improving the group/broker customer experience initiative.
  • Claims Funding and Billing
    • Manage claim funding billing process and collection, clearly identifying management status of accounts.
  • Coordination and Development
    • Responsible for coordination and development of IT requirements, validation of data and output, and regular interaction with Communications and Fulfillment to ensure timely and accurate mailings.
  • Support and Leadership
    • Support Management and staff by resolving group/broker questions and escalated issues.
    • Lead and conduct staff meetings, and attend cross-functional business unit and corporate team meetings.
Requirements
  • 5 years of relevant work experience in the health insurance industry
  • 3 years in a management or leadership role
Preferred Qualifications
  • Experience in a range of operational settings in the health insurance industry (e.g., customer service, claims, business support)
Education
  • Bachelor's degree or relevant experience and/or education as determined by the company in lieu of bachelor's degree
Licenses or Certifications
  • Project Management Certification
  • Six Sigma Certification
Skills
  • Strategic thinking/planning skills
  • Excellent time management & organizational skills with a strong attention to detail
  • Excellent verbal and communication skills
  • Strong analytical skills with the ability to implement effective solutions with a short term and long term focus
  • Demonstrated coaching and staff development skills
  • Project management skills
  • Ability to work in a fast-paced environment and be able to multi task with daily work processing deadlines
  • High energy level and ability to project enthusiasm
  • Persuasive communication style
  • Ability to understand all customer needs (group, broker, provider, etc..) and the interconnection of all core and ancillary systems
  • Microsoft Word, Excel, PowerPoint, Access – Intermediate

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