The Case Installation Consultant independently manages and oversees the account installation activities within the implementation process across multiple functional areas within and outside of Kaiser Permanente. The installation process creates a seamless, transparent, and organized implementation experience for the organization, employer group purchaser, vendor(s), third-party administrator, and consultant/ broker. The Case Installation Consultant project manages and coordinates all activities required to implement the employer group that begin once the purchaser/customer chooses their medical and/or dental plan(s) through the point in which members receive clinical services and the group receives its first invoice. The Case Installation Consultant resolves varied and complex issues involving departments throughout MSBD, HPSA and National departments, or escalates as appropriate within and outside of the organization to ensure a successful installation for those purchasers to whom these concierge services are provided.
Essential Functions:
- Facilitate customer-facing mtgs/conference calls to present complex information related to group set-up requirements & installation activities including EDI transmission, etc.
- Create & negotiate agreements w/ the purchaser regarding installation timelines, process & implementation plans.
- Represent the interests of purchasers who have complex needs or whose administrative requirements or benefits represent difficult challenges for implementation, perform analysis that drives strategic problem solving & build consensus among parties to ensure successful results.
- Project manage, coordinate tasks & maintain installation timelines across multiple functional areas, working w/ department Directors, Managers & subject matter experts.
- Direct key Case Installation meetings: Sales Strategy, Customer Implementation, Expert Team, Eligibility Engineering including EDI processes.
- Facilitate internal & external stakeholder meetings during the installation process for problem resolution, implementation timing changes, error management & other issues.
- Provide primary oversight of account set-up in Common Membership.
- Perform quality audits on account set ups (i.e. rates, benefits, group structure, billing & eligibility parameters, contract validation & invoice accuracy) & oversee the scrubbing of enrollment applications, when applicable.
- Ensure functional departments understand & comply w/ established processing & turn-times.
- Resolve issues during the installation & renewal processes, working directly w/ regional contacts & functional depts to ensure installations comply w/ standard process guidelines.
- Monitor the reconciliation of application, enrollment & fulfillment processes such as ID cards & member EOC's.
- Ensure member & group deliverables are correct & manage them to a purchaser's commitment date: Member ID Card, Member Explanation of Coverage, Group Contracts/Service Agreement, Group Invoice.
- Track all installation activities using SalesConnect & monitor those activities to identify potential risks or known issues.
- Use database to report on group-specific activities or summary statistics.
- Facilitate case transition meeting for hand-off to Sales or Account Mgmt staff, Membership Administration & other HPSA departments, by providing group-specific reporting metrics, issue review & installation process summary.
- This job description is not all encompassing.
Qualifications:
Basic Qualifications:
- Two (2) years of progressively responsible work experience in positions in a health insurance setting.
- Three (3) years of experience in project management or coordination of complex activities within sales/account management, contract implementation, purchaser installation or similar marketing or health insurance settings.
- Knowledge of and general experience in health care insurance (i.e. sales, management, administration, etc.).
- Bachelor's degree in Marketing, Business, Finance, or Healthcare Administration, or a related field, and/or equivalent work experience.
- Licensed Health Insurance Agent or obtain license within ninety (90) days of hire.
- Medicare training subject to regulatory CMS requirements.
- Demonstrated excellent customer service skills
- Excellent attention to detail and organization skills.
- Strong project management skills and knowledge of project management protocol and tools.
- Demonstrated ability to track outstanding issues, and ensure appropriate follow-up.
- Demonstrated ability to make appropriate and successful decisions based on accurate assessment of available information.
- Strong interpersonal skills in face-to-face and virtual relationships.
- Demonstrated self-starter and able to work independently.
- Demonstrated excellent written and oral communication, collaboration, and negotiation skills.
- Ability to facilitate in-person and teleconference discussions with internal business partners, and external customers to achieve desired goals.
- Exposure to various customer facing and team settings.
- Proficient in Microsoft Office Suite and Lotus Notes.
- Common Membership, Diamond, TOPS, Tapestry, HealthConnect, ONYX, FASET, SPARCS, and other supporting systems.
- Working knowledge of COBRA, Medicare/Medicaid, HIPAA, and TEFRA regulations.
- Ability to travel within the NW region.
Preferred Qualifications:
- Exposure to SOX activities and guidelines is preferred.
- Exposure to Sales and Account Management functions preferred.
- Proficiency in Membership Administration common eligibility and billing practices is preferred.
- Proficiency in Benefits Administration systems preferred.
- Exposure to Contract production and administration preferred.
- Quality Audits of benefit, group setup, administration, and systems preferred.
Salary Range:
$66,740 - $91,460
External hires must pass a background check/drug screen.
We are proud to be an equal opportunity/affirmative action employer.