Manager Group Implementation and Funding Management Business Support

Highmark Health

Full-time - Manager

Remote

Insurance Carriers and Related Activities

About the position

The Manager of Group Implementation and Funding Management Business Support at Highmark Inc. is responsible for the strategic implementation of new or transitioned accounts while managing a team of professionals. This role encompasses a wide range of responsibilities, including overseeing Administrative Services Only (ASO) and Third Party Administrator (TPA) services, particularly with an expanded BCI/HNAS offering. The incumbent will manage claims funding and cash management, while also identifying and driving process improvements across the HNAS Business Support and Group Implementation operations. This position plays a critical role in projects and activities that impact the Sales and Operations and claims finance business unit functions. In this managerial role, the incumbent will perform various management responsibilities, which include hiring and termination decisions, coaching and development of staff, performance management, and ensuring staff productivity. The manager will plan, organize, staff, direct, and control the day-to-day operations of the department, developing and implementing necessary policies and programs. Budgetary responsibility may also be part of this role. The manager will oversee the performance of dedicated Implementation Coordinators who are responsible for managing and implementing key accounts, including new groups and key renewals. Acting as a liaison for group changes, the manager will coordinate between various departments such as Information Technology, Account Operations, Billing & Enrollment, and others to ensure timely and accurate results. This includes organizing internal Group Implementation meetings, developing project plans and status reports, and identifying potential issues. Additionally, the manager will participate in process improvement initiatives aimed at enhancing the group/broker customer experience and support technology initiatives that align with this goal. Responsibilities also include managing the claim funding billing process and collection, ensuring clear management status of accounts, and coordinating IT requirements and data validation. The manager will support staff by resolving group/broker questions and escalated issues, lead staff meetings, and attend cross-functional business unit and corporate team meetings. Other duties may be assigned as necessary.

Responsibilities

• Perform management responsibilities including hiring, coaching, and performance management.
• Plan, organize, staff, direct, and control the day-to-day operations of the department.
• Develop and implement policies and programs as necessary, with potential budgetary responsibility.
• Manage the performance of Implementation Coordinators for key accounts and renewals.
• Act as a liaison for group changes between various departments to ensure timely and accurate results.
• Coordinate internal Group Implementation meetings and develop project plans and status reports.
• Participate in process improvement initiatives to enhance customer experience.
• Manage claim funding billing process and collection, identifying management status of accounts.
• Coordinate and develop IT requirements and validate data and output.
• Support management and staff by resolving group/broker questions and escalated issues.
• Lead and conduct staff meetings and attend cross-functional business unit meetings.

Requirements

• 5 years of relevant work experience in the health insurance industry.
• 3 years in a management or leadership role.
• Bachelor's degree or relevant experience and/or education as determined by the company.

Nice-to-haves

• Experience in a range of operational settings in the health insurance industry (e.g., customer service, claims, business support).
• Project Management Certification.
• Six Sigma Certification.