Renewal & Services Director

MCS Healthcare Holdings, LLC (MCS)•San Juan, PR

20h•Onsite

About The Position

Responsible for directing, developing initiatives, and establishing plans of action to ensure compliance with service standards, comply with the needs of internal and external clients, and achieve the renewal goals established by the company. Responsible for the service and renewals of the groups under portfolio.

Requirements

Bachelor's Degree in Business Administration, Public Administration, Health Services Administration, or related areas.
At least seven (7) years of previous experience in customer service, account management, or performing similar functions in the Healthcare Insurance Industry is preferred.
At least three (3) to five (5) years of experience supervising staff.
A Driver's License valid in the Commonwealth of Puerto Rico is required.
Candidates or current employees who do not possess the required Office of the Commissioner of Insurance (OCS) licenses (Health Services, Disability and Health, and Life) must commit to obtain the required licenses by successfully passing the examination(s) administered by the Office of the Commissioner of Insurance (OCS).
Newly hired employees must obtain the required licenses within six (6) months of their hired date following the issuance of a provisional license.
Current employee’s who are issued a provisional license must obtain the required license(s) within six (6) months of the provisional license issuance date.
Employee’s must successfully pass the licensing examination(s) on the first examination(s) attempt paid by the Company. Any additional examination(s) attempts will be employee’s responsibility.
Car in good condition and available to travel to different locations in Puerto Rico.
Spanish – Advanced (comprehensive, writing and verbal)
English – Advanced (comprehensive, writing and verbal)

Nice To Haves

At least seven (7) years of previous experience in customer service, account management, or performing similar functions in the Healthcare Insurance Industry is preferred.

Responsibilities

Develops business initiatives to achieve and exceed the group retention and growth rates established in the budget by the Board of Directors of all the groups in the commercial and government portfolio, insured or self-insured.
Ensures that the established processes for receiving, evaluating, and sending the renewal proposal are completed and in compliance with the regulation established by the OCS (Office of the Insurance Commissioner) and the internal processes.
Evaluate clients' needs regarding Medicare benefits, make recommendations, and request proposals to the corresponding unit or department.
Negotiate coverage and rates with the corresponding internal unit or department.
Participates in meetings with clients/insurance agents and the management to reach agreements, renewals, and solutions to service cases.
Ensures the team analyzes, prepares, and discusses the utilization reports in agreement with the established calendar and the employee group number, if applicable.
Participates in meetings with key groups.
Participates in sensitive accounts' implementation process assigned by the management to ensure it is done properly. Once the group is implemented, make sure to follow up on the reached agreements.
Intervene in sensitive and complex cases that could affect the group's retention and get to a solution between the company's different departments.
Assigns to the unit to new groups, considering the segment to which the group belongs, the financial arrangement and client profile.
Collaborate with the accounts executive to solve complex service and renewal cases that are at risk.
Participates in activities, meetings, presentations, and trips abroad that are requested to represent the company, and in meetings with producers to define the services strategies for FI/CP groups.
It is a requirement to commit and actively participate in recurring continuing education courses and webinars from the Office of the Commissioner of Insurance (OCS) to ensure compliance with all requirements necessary to obtain and renew the licenses required for the successful performance of the position's essential functions.
Supervises, monitors, trains, evaluates, and corrects personnel among others to comply with his/her role as a supervisor, to assure that his/her personnel fulfill their work plan and comply with their essential functions and that they behave according to the policies, standards, norms, and procedures of the Company.
Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices.
May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document.