Client Implementation Manager - PBM - REMOTE

Amwins-posted 2 months ago
Remote • North Kingstown, RI
5,001-10,000 employees
Insurance Carriers and Related Activities
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The Implementation Manager is responsible for implementing client health care plans per client and regulatory specifications and projects related to benefits and claims activity. This role involves providing analysis to correct and improve processes and addressing problems that arise. The Implementation Manager may also be called upon to implement new regulatory changes that impact the business.

  • Lead new employer, Union, and TPA implementation processes, including driving client, consultant/broker, and data partner meetings to gather and document requirements for internal and external teams.
  • Gather Group benefit setup terms and effectively communicate to downstream entities for plan building.
  • Ensure operational and technology readiness for launch and obtain readiness signoff for all necessary stakeholders.
  • Monitor launch activity to identify any potential issues and develop rapid response plans to implement solutions and remediation efforts.
  • Identify project risks and mitigation strategies and communicate to the appropriate stakeholders.
  • Keep rework events for plan build events below 5% (as measured by both client event and situational event).
  • Manage downstream entities, new group setup, and changes, to meet expected deadlines and client expectations for Medicare and Commercial Book of Business.
  • Identify issues that can increase risk of delay or failure per client's benefit requirements.
  • Communicate issues to appropriate personnel.
  • Adjust requirements to minimize risk or seek client adjustment through Account Management.
  • Log all new/change requests to manage deliverable dates.
  • Manage all signoffs by filing all documents to evidence the requirements and signoffs.
  • Manage Implementation for accuracy and timeliness.
  • Document and maintain process that ensures timely, authorized updates.
  • Provide documents for review by all key stakeholders.
  • Maintain Client signoff document.
  • Define implementation timeline to provide Sales and Account Management with expected timeframes for common scenarios.
  • Update internal documentation with new and terminating groups.
  • Update Optum with new and terminating groups.
  • 3-5 years of experience in a similar role or project management.
  • Bachelor's degree, or combination of education and offsetting experience.
  • Client facing experience is a plus.
  • Broad understanding of health benefits plan setups (copays, drug coverage, and accumulators).
  • Demonstrated business analysis skills in the health care benefits industry.
  • Experience or knowledge of pharmacy benefit manager and Medicare Part D is a strong plus.
  • Reporting tools experience is a strong plus.
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