Job Description :
Responsible for developing and maintaining the model documents that are the basis for producing group benefit booklets and contracts to ensure favorable group relations and to conform to the Plan’s legal requirements.
Author (write code and map to appropriate information source or database) for both new and changing products, benefit information, processes, administration of provisions, system updates, software releases, web site updates, and any additional systems or processes that impact the area.
1. Automated Publishing System – Develop, set-up, and provide maintenance, language review, write specifications, develop business rules, identify variables, map to database sources, code, write SQL statements for the Automated Publishing System.
2. Documents – Ensure group benefit booklets, contract documents, Summary of Benefits and Coverage, renewal and various letters are favorable to group relations and compliant with all corporate legal requirements.
3. System Analysis – problem identification, research and solution implementation related to group benefit data. Perform analysis, design, programming, testing and implementation of software upgrades.
4. Author new as well as modify existing documentation to reflect the changes from the projects, revised business practices, benefit design, corporate initiatives, mandates, regulatory findings, health care reform, etc. Design a testing plan and perform extensive testing to ensure accurate implementation.
5. Perform language content review and design, formatting and brand compliance for the numerous model documents maintained in the document management system.
6. Other duties as assigned or requested.
- A High School Diploma or GED
- 3-5 years of relevant, progressive experience in the analysis of business processes to include one or more of the following: Knowledge of process functionality or understanding of products, benefits, and benefit databases.
- Bachelor’s degree in Business Administration, Computer Science or Computer Programming or two (2) years experience in electronic publishing, database technologies or programming
- Medicaid Experience
Knowledge, Skills and Abilities
- Intermediate to advanced level of knowledge regarding all Highmark products, benefits, health programs and systems is essential.
- Strong organizational, analytical and interpersonal skills essential.
- Intermediate knowledge of rating methodologies and rating procedures.
- Ability to present to groups, develop training documentation, create process/technical documentation.
SCOPE OF RESPONSIBILITY
Does this role supervise/manage other employees?
Is Travel Required?
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.
Referral Bonus: Level 1
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