Job Description:
• Request historical files from advisor or client, and review layout as needed.
• Host the TPA implementation meetings.
• Review data transmission process, file layouts, timing, etc..
• Determine system hierarchy requirements and build in CRM.
• Coordinate eligibility test files, updates, and production.
• Coordinate claims extracts with all vendors (TPA, stop loss, advisor).
• Coordinate ID card from TPA for approval.
• Validate eligibility files and extracts post go live.
• Conduit to the Navitus eligibility and claims extract teams.
• Manage data sharing policies and Non-Disclosure Agreements with vendors.
• Submit data and service requests, and ongoing monitoring to ensure accurate, timely completion.
• Troubleshoot any vendor issues to ensure quick resolution, including support of the account teams in helping to facilitate resolution of escalated file issues.
• Suggest and implement new vendor management processes, policies, and methods as needed.
• Identify and research expansion opportunities, in addition to the growing the client base with existing consultant/broker/TPA relationships.
• Other duties as assigned
Requirements:
• Bachelor's degree in Business, Marketing, or related area preferred.
• 3 years of vendor management experience (TPA’s, Consultants, Brokers, etc.), and working with external clients preferred.
• Knowledge of PBM or health care industry preferred.
• PC skills such as Microsoft Office, Email, etc.
• Participate in, adhere to, and support compliance program objectives
• The ability to consistently interact cooperatively and respectfully with other employees.
Benefits:
• Top of the industry benefits for Health, Dental, and Vision insurance
• 20 days paid time off
• 4 weeks paid parental leave
• 9 paid holidays
• 401K company match of up to 5% - No vesting requirement
• Adoption Assistance Program
• Flexible Spending Account
• Educational Assistance Plan and Professional Membership assistance
• Referral Bonus Program – up to $750!