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Assistant Director, Operations

Company: 1199SEIU Benefit and Pension Funds
Location: New York
Posted on: January 15, 2021

Job Description:

  • Oversee the Eligibility department operations and assist the--Director--in the--development, implementation and enforcement of--Fund policies and procedures as they relate to member eligibility data, Summary Plan Descriptions, Benefit Plan Design changes and provisions of--Collective Bargaining Agreements
  • Oversee--monthly eligibility reconciliation reports including--updates of the Funds' membership data;--analyze enrollment data and provide reports to Director with--accurate enrollment--metrics. forecasting and monthly cost center budgets
  • Oversee the eligibility and monthly maintenance of Job Security Fund, Training and Upgrading Fund updates to the V3 system
  • Oversee administrative functions of member eligibility 1 st level and 2 nd level appeals related to Coordination of Benefits, COBRA and health benefits for active members and retirees
  • Oversee administrative functions related to internal and external audits, timely response and provide recommendation and implementation of process improvements and enhanced quality controls
  • Review and monitor quality control reports to ensure the integrity of eligibility data and--monitor benefit suspensions;--wage class and eligibility class changes, analyze membership data information as reported by--eligibility system, make recommendations for improvement based on trends, business--best practices and incorporate appropriate checks and--balances
  • Assist in the implementation of new eligibility and enrollment system (Vitech-V3); appropriately address discrepancies,--testing,--upgrades,--data conversions and--effectively meet project timelines and deliverables
  • Provide administrative support in overseeing the ongoing maintenance of the Funds Medicare Advantage Plans, Employer Group Waiver Program, Retiree Drug Subsidy
  • Provide administrative support in the implementation, testing and ongoing maintenance of the Employer Portal, Employment Event GUI to ensure all updates to the V3 system are in alignment with the departments operational procedures and eligibility guidelines
  • Supervise--management and Eligibility Staff;--hire, train, and evaluate--performance in accordance with Human Resources guidelines,--procedures, and provisions of Collective Bargaining Agreement
  • Conduct strategic planning sessions to analyze department operations, workflows and--improve performance; ensure--department goals and objectives are in alignment with the overall vision of the organization and the Strategic Support Division
  • Ensure appropriate protocols are in place to--maintain the integrity and security of member enrollment and eligibility data--received from members, employers, and union to successfully--complete the end to end member enrollment process
  • Complete additional projects and--responsibilities as assigned
    Qualifications
    • Bachelor's Degree in Business Management, Health Administration, or equivalent years of experience required
    • Minimum six (6) years senior level experience managing--Healthcare--Eligibility Data and--Enrollment--in a health insurance environment required;--or--six (6) years--Quality Assurance, Healthcare Operations--or Benefits Administration experience in a health--benefits environment required
    • Minimum of four--(4) years -- supervisory experience--with a large staff--(exempt and non-exempt)--required
    • Experience with--quality control,--process improvement,--data integrity,--analyzing metrics--and--making recommendations for improvement based on trends and--business--best practices
    • Experience in--pension or union environments--highly preferred
    • Experience in CMS and MSP rules and regulations related to retirees and active working members highly preferred
    • Experience--managing multiple projects under strict timelines and meeting overall goals and objectives required
    • Ability to make independent decisions concerning management, planning, scheduling and assignment of work
    • Experience developing policies, procedures and implementing strategies to meet objectives of excellence in a dynamic environment
    • Excellent leadership skills a must;--experience--coaching, mentoring, motivating and--creating improvement plans to meet or exceed service level expectations
    • Experience in developing strategic plans and metrics to measure level of achievement
    • Exceptional organizational,--time management and analytical skills Who We Are
      Join Our Team
      Privacy Policy
      Vendor Terms & Conditions 1199SEIU Funds
      330 West 42nd Street
      New York, NY 10036(646) 473-9200

Keywords: 1199SEIU Benefit and Pension Funds, New York , Assistant Director, Operations, Executive , New York, New York

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