Summary of Position

Lead the technical implementations for the ASO, Shared Administration and Network Access Programs with Third Party Administrators (TPAs) as required. Manage the maintenance and enhancement of ASO including Shared Admin and Network Access product offerings. Collaborate with marketing teams to develop materials and tools that support sales and education efforts. Collaborate with internal stakeholders to resolve issues related to the needs of the ASO, Shared Administration and Network Access programs. Provide input on benefit design changes and assist in documenting updates to ensure clarity and consistency for ASO, Shared Admin and Network Access clients. Partner with Sales/Account management teams by providing expertise of technical documentation, ASO, Shared Administration and Network Access product and process. Research market trends, competitor products, and regulatory changes to provide insight and support product updates and improvements

Principal Accountabilities

Manage operational processes specific to ASO, Shared Admin, Network Access and Large Group segments. Work with IT and operations teams to ensure systems are configured correctly for ASO, Shared admin, Network Access and Large Group segments including eligibility, billing, and reporting functions. Manage the implementation and the technical specifications of ASO , Shared Administration and Network Access. Monitor any implementation updates related to ASO compliance, including ERISA, ACA, and HIPPA regulations. Assist in analyzing market trends, client feedback, and competitor offerings to identify opportunities for enhancements. Contribute to the development of strategies for improvement and growth of ASO product offerings. Serve as the business SME to internal & external constituents on the ASO, Shared Administration and Network Access programs. Develop and maintain cross-functional relationships. Engage the appropriate business/operations areas to research issues identified for ASO, Shared Administration and Network Access programs. Assist in resolving escalated client issues related to operational or benefit design challenges. Manage and respond to large group ASO client questions, offering detailed explanation of plan structures and operational processes. Lead internal/external conference calls: planning, follow up, meeting scheduling, documentation preparation and call notes distribution. Manage Sales/Account management teams by providing explanation of the ASO, shared Administration and Network Access programs workflows. 

Qualifications:

Bachelor’s Degree. 4 – 6+ years of relevant, professional work experience required Extensive knowledge of ASO products, funding arrangements, and related services required Strong understanding of health care regulations (ERISA, ACA etc.) and compliance requirements required Familiarity with health plan pricing, claims administration and benefit designs required Experience in claims and EDI transactions (837, 835, etc.) required Additional experience/specialized training may be considered in lieu of educational requirements required Self-starter: ability to work on issues without being prompted and seeing issues through to completion required Detail oriented; analytical and problem identification and resolution skills required Strong data analysis skills; ability to discern patterns and trends required Excellent collaboration skills and the ability to influence management decisions required Excellent communication skills (verbal, written, presentation, interpersonal) with all types/levels of audience required Proficient with MS Office (Word, Excel, PowerPoint, Outlook, Teams, SharePoint, etc.) required Knowledge of/proficiency with applicable systems and platforms (FACETS, TruProvider and Salesforce) required Exceptional organizational and project management abilities to handle multiple priorities preferred Additional Information Requisition ID: 1000002348 Hiring Range: $63,000-$110,000