Mgr Contract Administr Ops

Health Care Service Corporation•Chicago, IL

6d•$92,700 - $167,500

About The Position

This position manages the unit responsible for producing customer-specific documents for new and existing business in accordance with corporate guidelines, underwriting policy, benefit specifications, and statutory requirements. The role manages performance, quality, and resource allocation across product lines, including sales support from benefit selection through booklet delivery. It oversees the creation and maintenance of standard and custom booklets and implements strategies, projects, and initiatives. The manager leads the Enterprise Contract Administration unit, which drafts, vets, and files group and retail member and employer documents, including documents for Exchange Affected Markets. The role provides subject matter expertise on employer and member documents, oversees document updates and compliance, and manages employer contract negotiations and document version control. People-management responsibilities include hiring, budgeting, training, performance and pay administration, change management, succession and talent planning, and applying corporate and Human Resources policies and programs. The position also leads special projects and legislative task forces, prepares performance and issue-resolution reports, supports responses to Department of Insurance or legal inquiries, and communicates with colleagues, management, customers, and other stakeholders. The manager must comply with HIPAA and applicable corporate and departmental policies and maintain confidentiality.

Requirements

Bachelor's degree and 5 years of health insurance contract operations experience, plus 1 year of management experience; or 9 years of health insurance contract operations experience, plus 1 year of management experience.
Knowledge of health products and procedures, underwriting requirements, and contract and funding arrangements.
Analytical and reporting skills.
PC proficiency, including the Microsoft Office Suite.
Project management skills.
Customer service experience and acumen.
Leadership skills.
Verbal and written communication skills to manage staff and operations, build relationships across the organization and with external key stakeholders, build consensus, and resolve issues.

Nice To Haves

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.

Responsibilities

Manage personnel and units responsible for drafting, vetting, and filing group and retail member and employer documents, including Exchange Affected Markets.
Manage employer contract negotiations, including signature tracking and custom provisions, and maintain documents, version control, and updates.
Provide subject matter expertise on employer and member documents, including certificate booklets, ASAs, and BPAs.
Manage updates to member and employer masters and ensure documents comply with policies, regulations, and Blue Card language.
Oversee creation and historical maintenance of standard and custom certificate language in accordance with local Department of Insurance statutory requirements and internal HCSC policies and guidelines.
Manage staff and people processes, including hiring, training, budgeting, performance management, pay administration, change management, succession planning as needed, and talent management.
Act as project leader for special projects and legislative task forces.
Prepare and communicate routine performance-management reports and issue resolution.
Ensure deviations from policies, procedures, and guidelines are reviewed and approved.
Assist with preparing responses to Department of Insurance or legal inquiries involving specific accounts.
Communicate and interact effectively and professionally with coworkers, management, customers, and other stakeholders.
Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies, and other applicable corporate and departmental policies.
Maintain complete confidentiality of company business.
Keep management informed about developments in assigned areas and perform special projects as required or requested.