Campus Pride Jobs

Job Description:

Summary:

This role is responsible for the drafting, review, and maintenance of new and existing group agreements and riders, financial arrangement documents for new account sales and existing account renewals. The incumbent is responsible for the interpretation of legislative mandates and identification of impact on group agreement templates and addendums. The Coordinator ensures actions and documents are in compliance with Federal and New York State Department of Financial Services (DFS) and BlueCross BlueShield Association regulations.

Essential Accountabilities:

Level I

Creates group agreements and other legally binding documents containing the group demographics, product rates, financial arrangement, renewal dates and member legal documents. Analyzes requests for new benefits, new products, mandates and account specific changes to determine impact to existing legal documents (member or group). Identifies all existing legal documents that may be impacted.

Analyzes benefit and rate information on group support systems (PEGA/SAHC, Seibel, Stepwise Salesforce or membership systems) for all new and renewing groups to initiate the group agreement process. Creates and executes PEGA/SAHC, Step Wise and Seibel, Salesforce reports to identify new and renewing groups.

Works in tandem with Sales and Marketing, Rating & Underwriting, and internal and external legal Counsel to ensure new group agreements are accurate and meet regulatory requirements. Audits and identifies groups requiring group agreements.

Provides sales support by providing target dates, forms, impacts and guidance on contract process. Initiates the contract process by contacting appropriate sales consultant or account service representative whenever necessary.

Creates and revises metric reporting for management to support tracking of legal document activity as needed. Maintains accurate records on all designated systems following established policies (PEGA/SAHC, Seibel, Contract Development System, Department Share drive, Salesforce, Teams and/or SharePoint as applicable).

In conjunction with Attorneys, responds to regulatory inquiries within designated timeframes. Demonstrates adherence to all internal controls, all regulatory requirements and provides explanation, as required.

Functions as division/company representative on assigned corporate teams involving project implementations and/or evaluation of company practices. Works with team members to create process improvements, supporting documentation and complete final implementation.

Obtains rates and Underwriting review of legal documents to ensure group type, product descriptions, financial arrangement and product rates are accurate.

Collaborates with and coordinates, as necessary, legal support for custom group agreements and participates in all Corporate Legal/Sales/Client meetings to ensure understanding of commitments.

Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs.

Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.

Regular and reliable attendance is expected and required.

Performs other functions as assigned by management.

Level II (in addition to Level I Accountabilities)

Effectively navigates and trains on the process required to analyze all benefit and rate information on group support systems (e.g., PEGA/SAHC, Contract Development System, Seibel, Stepwise, Salesforce, or membership systems). Creates and executes system reports.

Identifies changes and works in conjunction with Attorneys to revise legal document templates. Acts in a consultative capacity to staff of all levels to provide professional technical expertise in determination of suitable approaches to creation, regulatory submission and implementation of legal documents.

Creates complex group agreements; defines financial mechanisms, selects the correct document template appropriate to group structures, and negotiates (on content) for group agreements and other legally binding documents. Works in partnership with rating and underwriting staff to validate and ensure financial arrangement descriptions and product rates are accurate for complex and negotiated groups. Engages Corporate Legal support as required to create custom group agreements.

Researches and drafts responses to external account inquiries on group agreements. Determines need and seeks Attorney review when appropriate.

Identifies and leads projects to implement approved process improvements. Prepares and delivers necessary written and oral presentations.

Maintains thorough knowledge of all products, benefit interpretations and available financial arrangements.

Provides training and guidance to the Regulatory Document Development and Delivery staff as needed.

Minimum Qualifications:

NOTE: We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities.

Level I

Seven or more years' experience working on contract agreements in the health care industry or Bachelor's degree in Business Administration, Communications or related field with three or more years' experience in the health care industry.

Two or more years technical or business writing experience.

Demonstrated understanding of health insurance group financial arrangements and member contracts and riders preferred.

Familiarity with State & Federal legislative mandates, laws and revisions and BCBSA rules and guidelines preferred.

Familiarity with systems including Facets, PEGA/SAHC, Seibel, Stepwise, Outlook, Teams Salesforce and SharePoint.

Strong analytical ability and project management skills.

Excellent oral, written, and presentation skills.

Capable of establishing constructive relationships with internal and external staff and management of all levels. Ability to maintain professionalism and poise under pressure. Experience strategizing with management staff and Attorneys.

Ability to prioritize assignments, work independently and handle confidential information with discretion is essential.

Demonstrated proficiency in Microsoft Office Suite (Word, Excel, and PowerPoint) and Adobe Acrobat Professional.

Level II (in addition to Level I Qualifications)

Demonstrated knowledge of BCBSA, Federal and New York State regulatory requirements including the ability to utilize on-line Federal and NYS web sites.

Three or more years of progressive group agreement document development demonstrating expertise and proficiency in drafting and execution of both standard and complex group agreements, negotiated group agreements and other legally binding documents.

Demonstrated proficiency with corporate systems supporting legal document data.

Provide accurate metric reporting to all levels of management regarding group agreement inventories.

Physical Requirements:

Ability to work prolonged periods sitting and/or standing at a workstation and working on a computer.

Ability to travel across the Health Plan service region for meetings and/or trainings as needed.

**

One Mission. One Vision. One I.D.E.A. One you.

Together we can create a better I.D.E.A. for our communities.

At the Lifetime Healthcare Companies, we're on a mission to make our communities healthier, and we can't do it without you. We know diversity helps fuel our mission and that's why we approach our work from an I.D.E.A. mindset (Inclusion, Diversity, Equity, and Access). By activating our employees' experiences, skills, and perspectives, we take action toward greater health equity.

We aspire to reflect the communities we live in and serve, and strongly encourage people of color, LGBTQ people, people with disabilities, veterans, and other underrepresented groups to apply.

OUR COMPANY CULTURE:

Employees are united by our Lifetime Way Values & Behaviors that include compassion, pride, excellence, innovation and having fun! We aim to be an employer of choice by valuing workforce diversity, innovative thinking, employee development, and by offering competitive compensation and benefits.

In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.

Equal Opportunity Employer

Compensation Range(s):

Minimum $58, 500 - Maximum $81, 702

The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position's minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays.

Please note: There may be opportunity for remote work within all jobs posted by the Excellus Talent Acquisition team. This decision is made on a case-by-case basis.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Equal Opportunity Employer - minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity

Minimum Salary: 0.00 Maximum Salary: 0.00 Salary Unit: Yearly