Blue Cross Blue Shield of Rhode Island Team Leader, Contract Development & Analysis in Providence, Rhode Island
Team Leader, Contract Development & Analysis
Full Time | Job ID 567 | Posted: 03/10/2018
Supervise the daily work of staff responsible for developing group and member contracts, along with subscriber agreements. Ensure regulatory approval of documentation. Ensure documentation represents terms and conditions of managed care plans and adhere to business requirements, state laws, and regulation. Provide performance management oversight and employee development. Manage workflow of department; implement corporate or departmental policies, procedures, and service standards.
ESSENTIAL JOB FUNCTIONS:
Coordinate the workflow and operations of the department. Provide direction and guidance to staff. Review and evaluate work and prepare performance reviews.
Oversee staff responsible for the development of group and member contracts, along with subscriber agreements; oversee and manage regulatory filings of group and member contracts; and ensure regulatory approval of documentation.
Manage the analysis of state laws and regulations as related to subscriber agreements. Ensure documentation complies with regulations and is approved by the Office of the Health Insurance Commissioner and Department of Business Regulation.
Oversee the timely and accurate development of subscriber agreement and group contract materials; ensure documentation represents terms and conditions of plans, services, and rates, as applicable.
Develop and issue large employer group contracts (self-funded and fully insured). Negotiate proposed changes, and track execution of documents.
Collaborate with internal business areas to identify changes to group contracts, subscriber agreements, and other member documentation. Oversee the drafting and filing process to ensure changes adhere to state and federal regulations and represent best interests of organization.
Establish and maintain positive working relationships with external regulators.
Keep abreast of and review filed documents to ensure compliance with applicable laws and regulations, including benefit mandates, HIPAA, and Office of the Health Insurance Commissioner.
Perform other duties as assigned.
Minimum Education and Experience:
Bachelor's degree in Business Management, Business Administration, or related field; or an equivalent combination of education and experience.
Three to five years of experience in contract development.
Preferred Education, Additional Qualifications, and Experience:
Supervisory experience or experience leading a team.
Knowledge of company benefits and products.
Required Knowledge, Skills, and/or Abilities:
General knowledge of laws and regulations affecting the health insurance industry.
Knowledge of benefits and products.
Understanding of group financial arrangements.
Ability to set and maintain quality standards.
Ability to develop and maintain effective and collaborative working relationships.
Strong and effective decision-making skills.
Strong organizational and time management skills.
Proficiency with Microsoft suite of products (i.e., Word, Excel, PowerPoint, etc.).
At Blue Cross & Blue Shield of Rhode Island (BCBSRI), diversity and inclusion are central to our core values and strengthen our ability to meet the challenges of today's healthcare industry. BCBSRI is an equal opportunity, affirmative action employer. We provide equal opportunities without regard to race, color, religion, age, national origin or ancestry, disability, veteran status, sexual orientation, genetic information, sex, gender identity or expression, and any other personal attributes protected by federal, state, or local law. For more information about our commitment to diversity and inclusion, please see our Diversity Report at bcbsri.com/diversityreport.
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BCBSRI is committed to working with and providing reasonable accommodation to individuals with disabilities. If, because of a disability, you need a reasonable accommodation for any part of our application process, please contact us at (401) 459-1050 for assistance.
During the application process, please allow a minimum of five business days before you contact our office to inquire about the status of your application. If you have any questions regarding your application or during the process, please contact Human Resources by phone at (401) 459-1050 or by email at email@example.com.
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