At UFCW & Employers Trust, every one of our staff is committed to providing efficient, responsive, friendly service and accurate information to serve all of our constituencies: our employee members, dependents, local unions, employers and service providers.
If you are looking for a an excellent opportunity in a great work environment, first class benefits, and opportunities to grow professionally, UFCW & Employers Trust wants to hear from you! We are currently seeking a Health & Welfare Eligibility Senior Manager professional to join our winning team.
In conjunction with the Senior Director of Health and Welfare Operations, the Health & Welfare Eligibility Senior Manager oversees the Eligibility and Enrollment unit within the Health & Welfare Services Department:
- Eligibility: A paperwork unit that processes documents related to active members, retirees, and providers.
- Sick Leave: A phone and paperwork unit that processes requests related to sick leave payment for members.
The Senior Manager will guarantee that the core functions of their unit are carried out by the individual management teams. This includes but is not limited to managing established performance metrics for each area, timely reaction for needed adjustments or changes, improving business processes, and ensuring the delivery and administration of health and welfare services are in compliance with collective bargaining provisions, plan rules, regulatory requirements, and directives from the Board of Trustees.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Directs team of supervisors, junior business analyst, and eligibility assistant.
- Directs and ensures the team of supervisors are holding 1:1 bi-weekly meetings with their staff, bi-weekly training for their staff, bi-weekly lead meetings, and monthly cross functional lead meetings.
- Ensures all staff within the department support and uphold the organizations Core Values; Trust, Integrity, Respect, Teamwork, Empathy, Commitment, Financial Prudence, and Innovation and embodies the virtues of The Ideal Team Player – Hungry, Humble, and Smart.
- Evaluates and assesses operations and processes in the department. Identifies options, alternatives, and recommendations for changes to policies, procedures, and operations in order to improve efficiency, establish high quality services, and accurate benefits administration.
- Ensures the department the departments “One Source Resource” reference tool is kept up to date by the junior business analyst.
- Ensures accuracy and timeliness of all activities in the Eligibility area including accuracy of benefit matrix for vendor utilization and accurate eligibility reporting to vendors, error resolution, receipt and retention of all enrollment paperwork, COBRA administration, renewal and open enrollment activities.
- Ensures the department functionality of premium invoicing, premium refunds, fulfill member requests for invoices.
- Ensures the processing of ID card requests, data file review for mass mailings and guarantee the accuracy of the data files, and cost controls.
- Ensures the processing of member sick leave payment requests.
- Develops the department staff development yearly plan, implements process improvements, special implementation of projects and adherence to company guidelines and policies. Department policy and procedure development and implementation.
- Identifies and implements processes and systems that will generate higher productivity, efficiencies, and ensure compliance and ensures continual program improvement.
- Ensures the development of policies, procedures, and workflows to meet department performance, quality and service goals.
- Establishes the annual department training plan and ensures the delivery of training and development programs for all subordinate staff in order to accomplish the organization’s goals.
- Accomplishes management objectives by interviewing and making hiring decisions, oversees the accurate development and implementation of training orientation, ensures timely submission of performance appraisals according to organizational expectations, ensures the enforcement of policies and procedures, and has authority to administer written warnings and make recommendations regarding termination of employment.
- Directs enforcement and ensures compliance with Office Policies, Collectively Bargained Agreements, State Law, and Federal Law in managing non-exempt collectively bargained employees, non-bargained non-exempt, and exempt employees.
- Holds supervisors accountable for time card processing to ensure they are completed timely accurately, in accordance with office policies, Collectively Bargained Agreements, State Law, and Federal Law for non-exempt collectively bargained employees and exempt employees.
- Develops and implements Quality Assurance programs. Analyzes work processes and the accuracy of eligibility services. Implement procedural changes as necessary.
- Manages vendor services and coordinates with vendors to ensure vendors successfully meet the vendor contracts, and project requirements. Review and approve monthly vendor bills according to vendor contract.
- Reviews and audits exempt staff work.
- Develop the Open Enrollment other insurance matrix for system configuration, Service Group matrix for compliance to Plan Level rules and all vendor benefit matrix for accurate eligibility and benefit quotes to medical providers.
- Manage the system eligibility configuration to ensure benefits are in accordance with Plan rules, review and approve system workflow changes/enhancements with significant organizational cost to secure increased efficiency, meet ACA requirements and SPD.
- Provides management, leadership, and coaching to departmental supervisors and Teams Leads.
- Review all member communications to certify compliance to benefit changes and ACA.
- Ensures the Health & Welfare Services Department are compliant with collective bargaining provisions, regulations requirements, plan rules and related requirements.
- Develops eligibility unit and management team goals as outlined by the organizational strategic plan, assesses needs and related activities for the department.
- Prepares department monthly and quarterly reports to include department statistics for analysis, implementation of strategic goals, and departmental accomplishments for submission to the Board of Trustees.
- Serves as liaison with counsel on clarification of benefits and documentation of Standard Operating Procedures.
- Ensures the preparation, timeliness, review of and presentation of member and provider appeals to the Board of Trustee Appeal Committee. Guarantees adherence to the Summary Plan Description appeal policy.
- Participates in development of annual department budget development and ensures that annual department budget is not exceeded.
- Supervises and establishes development plans for exempt employees.
- Develops department management meeting agendas and meeting notes; develops meeting structure and communications for all staff levels.
- Develops and ensures the implementation of the department training program.
- Direct communication with legal counsel, Plan Professionals for the clarification and/or development of Plan benefits, organization program development guidelines, contract review and development, vendor negotiations, policy and procedure development.
MINIMUM JOB REQUIREMENTS
- Bachelor’s degree from an accredited college or university in a related field and 6 years of related experience, including management experience.
- A combination of appropriate education and experience may be substituted for the minimum education and experience requirements.
- Certified Employee Benefits Specialist (CEBS) certification.
- Experience in a collectively bargained environment.
KNOWLEDGE, SKILLS AND ABILITIES REQUIREMENTS
- Excellent interpersonal skills with the ability to interact with all levels throughout the organization, vendors and Board of Trustees.
- Knowledge of applicable policies and procedures governing the hiring, employment and separation of employees.
- Skill in exercising a high degree of initiative, judgment, discretion and decision making to integrate organizational priorities, meet deadlines, and achieve objectives.
- Skill in creating and establishing criteria, techniques, and methodologies to resolve ongoing or unprecedented problems or situations for the Department, or the organization as a whole.
- Skill in providing high quality member service, including assessing and resolving TFO staff and members questions and needs while adhering to member service guidelines and procedures.
- Ability to comprehend and interpret legal verbiage and relate it to business functions.
- Ability to plan, develop and coordinate multiple projects.
- Ability to present ideas effectively, orally, and in writing.
- Ability to lead with vision and demonstrate strong leadership qualities.
- Ability to take initiative and drive organizational excellence.
- Ability to develop and implement managerial policies and prioritize the needs of the department.
- Ability to successfully resolve issues in a timely manner.
- Ability to work effectively in a team environment.
- Ability to handle confidential information with discretion and tact.
- Proficiency in the use of (or ability to learn) personal computer software or systems applicable to the essential functions of the job, which may include any or all of the following: email/calendar software, internet/intranet browsers, word processing, spreadsheets, database software, and various systems or software used by office.
PHYSICAL DEMANDS AND WORK ENVIRONMENT
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Work is performed in a standard office environment with possible minor inconveniences due to occasional noise, crowded working conditions, and/or minor heating, cooling, or ventilation problems. While performing the duties of this job, the employee is required to:
- Sit (regularly)
- Stand or walk (occasionally)
- Talk or hear (regularly)
- Use hands to finger, handle or feel (regularly)
- Reach with hands and arms (regularly)
Vision abilities required by this job include close vision and the ability to adjust focus. The employee is regularly required to lift and/or move up to 10 pounds and may occasionally be required to lift and/or move up to 30 pounds (such as a box of paper).
The intent of this job description is to provide a representative summary of the major duties, responsibilities, and requirements of this job. This document does not prescribe or restrict the tasks that may be assigned. Employees may be requested to perform job-related tasks other than those specifically presented in this description. This document is not a contract between the employee and the organization. The job duties and essential functions may change.
- We offer full medical, dental, vision, prescription drug, and pension benefits. In addition we offer paid vacation, generous holiday pay, and a competitive salary. This position is subject to a pre-employment negative drug screen and satisfactory completion of a background check.
Job Type: Full-time