Company :Highmark Inc.
Job Description :
This job is responsible for having in depth knowledge of the Client’s benefit designs, group structure, service model and clinical programs. The incumbent brings in-depth knowledge of benefits, problem solving, strong communication skill, member /client services as well as problem solving skill. The incumbent provides Client specific support to this Client and its Members to ensure a successful onboarding of the Client’s benefits and Highmark Products.
- Provide on-site support and educate Client and Members on business plans, in-network providers, service model and clinical models.
- Identify, research and track operational trends and issues based on customer interactions and customer feedback, transition details to the appropriate internal department (including but not limited to Product Management, membership, claims, eMarketing, etc) and provide resolution when possible.
- Collaborate with the Client, Sales Team, and HPO (Customer Service) on understanding of Client offerings to their members.
- Manage and build relationships at senior levels with clients, consultants, and brokers/producers by creating valued business partnerships, demonstrating business acumen by building up front sales strategies with the Organization's Sales team then executing these strategies by influencing member buying decisions at enrollment events to maintain and grow the Organization's enrollment and profitability
- Upfront development of sales strategies with the Organization's Sales Team on retention of terminated Organization group-based contracts by implementing the strategies and executing the individual product sales experience for enrollment and revenue growth. Team is CMS Certified for the Affordable Care Act to sell individual products on the marketplace to retain and/or gain medical and supplemental contracts and revenue.
- Participate in the upfront development of sales strategies with the Organization's Sales Team, then executing those strategies in sales situations by influencing member buying decisions to purchase supplemental Lines of coverage for growth and/or retention of contracts and increase profitability for HMIG products along with the dental and vision companies on a regional and national basis.
- In collaboration with Sales Client Management and Sales Executive team develop, implement, and execute the sales strategies to influence member level buying decisions to maintain and grow sales projections and profitability at enrollment events which include competing insurance carrier options.
- Participate in the development of communication strategies with the Organization's Sales Team, Consultants/Producers/Brokers and Clients to be able to explain and implement at a member level the most complicated product option. Achieved by the strategist executing these strategies by influencing the member’s decisions to effectively navigate through the healthcare system and network challenges which drives retention and growth of the Organization's contracts and impacts revenue and profitability.
- Other duties as assigned or requested.
- 3 years in a highly matrixed and complex management structure
- 3 years in the Health Insurance field working with health plans
- Thorough understanding of population health management
- Ability to work collaboratively with the Clinical Strategy Consultants, Clients and internal stakeholders
- Written and oral communication, analytical and inter-personal skills
- Strong member facing service skills
- Problem solving skills
- Conflict and crisis management skills
- Proactive and anticipatory approach to clinical
- High energy level
- Passion for the type of work described and sensitive to client needs
LICENSES or CERTIFICATIONS
- Bachelor's Degree
- 4 years of related and progressive experience in lieu of Bachelor's degree
Language (Other than English):
75% - 100%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Mostly on the road
Teaches / trains others
Travel from the office to various work sites or from site-to-site
Works primarily out-of-the office selling products/services (sales employees)
Physical work site required
Lifting: up to 10 pounds
Lifting: 10 to 25 pounds
Lifting: 25 to 50 pounds
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 job adheres to the 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 covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
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.
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, age, 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, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf )
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