Highmark Health-posted 11 days ago
Full-time • Manager
Hybrid
5,001-10,000 employees

This job manages the development and execution of short-term and long-term objectives to standardize business practices and enhance system applications. Actively participates in and leads projects. Develops and implements appropriate controls and processing methods and manage adherence to. Manages staff responsible for addressing daily system and process issues. Provides leadership in the development, implementation, management and accurate maintenance of all contractually-based producer arrangements. Establishes and maintain all operational and system processes across the organization to support producer arrangements. This role can be remote or hybrid - If you are within 50 miles of an office you are required to be onsite 3 days a week - T, W, Th.

  • 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.
  • Lead the delivery and execution of projects by: analyzing, identifying and problem solving business and systems issues; presenting recommendations to senior management; managing development of requirements, standard operating procedures, functional roles and responsibilities, process flow and user guides.
  • Serve in consulting/training role to direct reports to develop and execute comprehensive test scripts decreasing likelihood of defects to be corrected after implementation.
  • Identify, research, determine, implement and validate solutions, fostering an environment of continuous improvement across the organization.
  • Oversee ongoing analysis and implementation of procedures and systems.
  • Contribute to operational readiness, organizational change management, solution capability, packaging and estimating, planning and delivery management.
  • Lead the development and implementation of contractually-based producer arrangements by: interpreting and translating requests for enhanced business considerations; identifying operational capabilities and/or limitations in delivering requested enhanced business considerations; presenting and working through recommendations with senior management; defining operational process and necessary system development to implement and maintain agreed-to enhanced business communications.
  • Communicate enhanced business considerations and operational processes across the organization.
  • Establish and manage audit controls to ensure enhanced considerations are consistently and accurately adhered to.
  • Manages employees in the following analytical functions: 1) Analysis and approval of retroactive Producer changes, exception or advance payments, non-standard commissions, and requests for refunds from Producers; 2) Determination/ set-up of payment arrangements, data transfer, and licensure / appointment procedures for business partners; 3) Maintenance/dissemination of state requirements for producer appointment and licensing; 4) Production of complex reports for Sales, Producers, Business Partners, Regulators and other business areas and external parties; 5) Monitoring and internal auditing of various business partners relative to payment and producer of record accuracy, appointment compliance and other controls; 6) Maintenance of workflow procedures, form communications, and messaging.
  • Maintains master Producer contract forms, coordinates amendments and re-distribution of contracts, and works with the legal department on complex contractual issues and special language requests.
  • Acts as custodian/business owner of the payment processes and functional project manager of commission cycle.
  • Coordinates/approves payment system enhancements, relevant system requirements for corporate projects and business partner implementations.
  • Works with other business areas to resolve complex system issues and payment problems.
  • Other duties as assigned or requested.
  • 5 years in Healthcare, Technology or Project Management
  • 3 years in a leadership or management role
  • Customer focus, results orientation, strategic thinking, change advocate, continuous improvement, talent development
  • Knowledge of Producer agreements, commission payment calculation and how it interfaces with company financial systems.
  • Demonstrated competency in project execution and management of organizational units
  • Excellent written and verbal communication skills
  • Excellent leadership and interpersonal skills
  • Proven ability to build and sustain internal and external customer relationships
  • Experience evaluating and implementing technology
  • Presentation experience
  • Strong strategic development capabilities with creative problem-solving skills
  • 5 years performing or managing administrative and compliance processes related to Producer Relationships
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