Location: Hybrid
Compensation: $80,100 - $120,200

Jump into the new world of health insurance:

At Blue Cross & Blue Shield of Rhode Island (BCBSRI), our business is healthcare. But our focus is on improving lives. Be part of a team that is large enough to make a difference but small enough to be innovative. Work in a rapidly changing field. Take a chance to be creative. Move outside the status quo. Shape new ideas with the power of a national brand behind you.
 

Join others who know diversity is strength:

We appreciate and celebrate everything that makes us unique: age, national origin, citizenship status, perspectives, experiences, physical or mental disability, military status, race, ethnicity, religion, gender, sexual orientation, gender identity and/or expression. Our diversity strengthens us as an organization and helps us better serve an increasingly diverse Rhode Island population.
 

Why this job matters:

Deliver a differentiated end to end client experience to self-funded and complex local, regional and national customers of at least 5,000 subscribers.  Facilitate the day-to-day maintenance of these custom accounts inclusive of specialized benefits, enrollment files and vendor files/extracts.  Manage annual renewal and any new sale via the establishment of a Purchase Activation Request (PAR) and the engagement of a Project Manager to ensure accurate and timely implementations. Oversee the development of detailed project plans and support Sales staff in setting appropriate client expectations regarding claims and administrative billing, state mandates, reporting and other items that are unique to this financial arrangement/client. Resolve issues and answer inquiries regarding claims, billing, enrollment, benefits, and eligibility.  Conduct member, client, and broker education sessions to maximize the experience of doing business with BCBSRI.

What you will do:

• Serve as a dedicated, consultative, one stop resource to dedicated accounts.  Foster relationships with human resource and C-Suite personnel within accounts, as well as with the broker and consultants that owns that particular client.  Participate in client sponsored groups and events.

• Demonstrate a thorough understanding of all aspects of the ASC or complex account inclusive of stop loss, banking arrangements, ASO fees, broker commissions, etc, and a comprehensive understanding of downstream impacts of all client decisions to set appropriate expectations with the client and broker.

• Lead all annual renewal and off-cycle activities that pertain directly to the client(s) implementation.  With the support of internal resources you will ensure that products, eligibility, billing, and claims processing are configured and set up as requested. 

• Work in partnership with leadership for each client's Customer Care Center to resolve all daily and escalated issues and inquiries. 

• Record escalated concerns and operational issues in an internal project tracker utilized to facilitate weekly internal meetings with the operational team supporting the client (AE, PM, ESG Rep, etc.).  Manage all issues to resolution and deliver thoughtful, client-oriented responses inclusive of Customer Service and Employer Support Group messaging.

• Conduct member education sessions in the form of product and benefit presentations, health fairs, webinars, and trade shows, locally and nationally, as needed.  Proactively prepare schedule of Open Enrollment meetings by providing availability to clients giving priority to requests made by key clients. Develop and deliver open enrollment presentations inclusive of wellness offerings. Assess the wellness needs of employer groups and recommend solutions based on health promotion best practices.  Analyze population demographic data, claims history, and other data to determine health awareness, education, and intervention needs and opportunities within employer groups.  

• Work in tandem with the clients dedicated Wellness Consultant to design and deliver multi-year wellness strategies that include benefit package financial modeling, incentive design and compliance tracking systems. 

• Provide support to the Sales teams; complete, validate and monitor the PAR form and implementation post sale inclusive of broker commissions.  Prepare, maintain and delivery an annual key events calendar to the client and broker in conjunction with the Account Executive.  Perform reporting (including Member Study Requests) and utilization analysis for assigned accounts.

• Educate clients about available web-based tools and resources, including usage of electronic enrollment vehicles and 834 eligibility files.  Facilitate on-site Electronic Enrollment training as requested by the client.

• Thoroughly and accurately maintain Salesforce by populating all account activity, decision documents and contracts.

• Prepare new business and renewal packages, collateral kits, and benefit summaries. Work with Marketing Communications to create and update (annually) custom collateral, as needed.

• Provide status of monthly renewal progress/decisions at daily Renewal operations meetings to ensure timely account implementation.

• Remain current with the details of all products and services offered by organization, as well as federal and state legislation impacting operations.  Promote the products and direction of the organization to the customer and report back to the organization trends, issues, and situations uncovered in the marketplace.

• Participate in department initiatives and projects and perform other sales related and operational duties as assigned.

• Perform other duties as assigned.

What you need to succeed:

• Bachelor's degree in Business Administration, or related field, or an equivalent combination of education and experience

• Five to seven years' experience in healthcare, provider or customer service, marketing, sales, or related field
• Valid driver's license
• Knowledge of commercial products and benefits
• Knowledge of national healthcare trends, including healthcare reform legislation
• Advanced analytical skills, with the ability to interpret and synthesize complex data sets
• Working knowledge of Microsoft Excel, PowerPoint, and Word
• Good business acumen and political savvy
• Knowledge of business process improvement techniques and strategies
• Excellent verbal and written communications skills
• Negotiation skills
• Presentation skills
• Decision-making skills
• Good problem-solving skills
• Ability to interface with employees at all levels
• Ability to effectively navigate ambiguous situations with limited direction
• Excellent organizational skills and ability to successfully prioritize multiple tasks
• Ability to handle multiple priorities/projects

Location:

BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:

• In-office: onsite 5 days per week
• Hybrid: onsite 2-4 days per week
• Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia