Contract Administrative Operations Manager

BASIC FUNCTION:
This position is responsible for managing the unit responsible for the production of customer-specific documents for new/existing business in accordance with corporate guidelines, underwriting policy, benefit specifications, and statutory requirements. Manages the performance, overall quality and resource allocation to support all product lines, including key sales support components of benefit selection through booklet delivery. Oversee the creation and maintenance of standard and custom booklets. Implements strategies, projects and initiatives.

ESSENTIAL FUNCTIONS :

  • Draft and customize documents of low to the highest complexity based on member benefit and cost share data changes from the product portfolio or business areas.
  • Draft standard and non-standard contract language.
  • Negotiate with customers to develop benefit plans.
  • Draft special instructions/procedures for the Contract Administration Reference Library.
  • Responsible for filing within the guidelines of the State and Federal required artifacts.
  • Prepare responses to comments/questions from Stakeholder, Account Managers, Legal partners, and state peers.
  • Meet and sustain acceptable quality levels or above on accuracy and document delivery, based on departmental standards.
  • Communicate progress on drafting and filing development as well as assembly of the final member booklets
  • Maintain accurate and up-to-date records in database.
  • Communicate and interact effectively and professionally with co-workers, management, customers, etc.
  • Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
  • Maintain complete confidentiality of company related business.
  • Maintain effective communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.

  • JOB REQUIREMENTS:

    •Bachelor's degree and 5 years health insurance contract operations experience OR Master degree with 2 years health insurance contact operations experience.
    •Knowledge of health products and procedures, underwriting requirements, contract and funding arrangements.
    •Analytical and reporting skills.
    •PC proficiency to include Microsoft Office Suite.
    •Project management skills.
    •Customer service experience and acumen.
    •Leadership skills.
    •Verbal and written communications skills to manage staff and operations, build relationships across the organization and with external key stakeholders, build consensus and issue resolution.

    PREFERRED REQUIREMENTS:

    •J. D. degree or 4 years of experience in a leadership role with independent decision-making.
    •Knowledge of external adjudication processes.
    •Knowledge of large or national account contract specifications and processing systems.
    •Knowledge of corporate marketing practices, health insurance product lines and Par Plan operations.

    HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
    Requirements: Expertise Project Management, General Health Care, Government Programs, Regulatory & Compliance, Other Job Type Full-Time Regular Location IL - Chicago, TX - Richardson


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