Supervisor, Health Insurance

Supervisor, Health Insurance

Department: Health Insurance

Reports To: Senior Manager, Benefits

FLSA Status: FT

Last Updated: 2/1/2024

General Description:

Under the direct supervision of the Senior Manager, Benefits, the Supervisor, Health Insurance, is responsible for supervising the Health Insurance analysts and benefits business analyst in their daily tasks, collaborating with various departments, and facilitating the accurate enrollment and payment of rebates for CTPF members. The Supervisor, Health Insurance, takes a lead role in training, coaching, and developing other members of the Health Insurance team in enrollment processing, ensures timely benefit processing, and reports on established service level agreements.

Core Competencies

The Supervisor, Health Insurance, must demonstrate the following core competencies which relate generally to training and mentoring the team to solicit efficient and accurate processing. The Supervisor will also work to increase collaboration within the team and with other departments:

Primary Responsibilities

• Oversees the Health Insurance analysts and business analyst in their daily job responsibilities by training, goal setting, ensuring accurate benefit processing, and monitoring progress, including but not limited to application review, termination/eligibility analysis, correspondence to members, processing, and peer review of benefits, answering questions, and troubleshooting.
• Collaborates with the Senior Manager, Benefits, in hiring, supervising, motivating, and evaluating Health Insurance department staff, strategic initiative planning focused on improving efficiency and providing KPI statistics.
• Manages all aspects of benefits processing, including, but not limited to, workflow assignment, enrollment (annual and ongoing), rebate calculations, benefit review and reporting turnaround times.
• Assists Senior Manager, Benefits in creating and improving procedures for Health Insurance processes.
• Facilitates processing of enrollment and benefits by reviewing complex benefit calculations, reviewing documentation respective of eligibility, level of completion; and providing templates to assist in consistent calculations, review of payment reconciliations, address changes and vendor reports resulting in premium changes and possible adjustments as well as handling of data feeds.
• Acts as point of contact for the Health Insurance department processes for interdepartmental matters and support, including member escalations, training, and webinar support. Manages member escalations related to Health Insurance processes to full resolution, which may include emails or live member discussions.
• Operates as the Health Insurance subject matter expert in interdepartmental projects/concerns, coordinating with the Member Services, Finance, Benefits, Legal, and the EPMO departments, including but not limited to, leading meetings, and providing follow ups and minutes.
• Serve as backup to Senior Manager, Benefits, on matters of Health Insurance and as the backup for the benefits business analyst on invoicing, reconciliations, payroll processing, adjustments, premium updates, overpayment tracking, and reporting.
• Engage in implementation of new system, including but not limited to, providing requirements, all aspects of testing from creating test plans and test cases to testing.
• Assist with various projects in addition to completing cyclical transactional duties.
• Provides relevant status updates and information requests to management and Board of Trustees.
• Other duties as assigned.

Position Qualifications

• Must have strong mathematical and critical thinking skills.
• Excellent verbal and written communication skills.
• Strong analytical, organizational, and time management skills.
• Ability to work well in a team and cross-departmental environment.

Education and Experience

• Bachelor’s degree required with emphasis in Business, Human Resources, Finance, or Actuarial Science.
• Five to ten years of related experience with proficient knowledge of Health Insurance (including Medicare) and Health Insurance carriers.
• CEBS designation preferred.
• High level of proficiency in Microsoft Word, Excel, and PowerPoint.

Physical Requirements

• While performing the duties of this job, the employee will likely sit for long periods of time, with some standing and repetitive physical activity.
• The employee may occasionally lift and/or move up to 10 pounds.

Environment

• This job operates in a professional office environment. This role routinely uses standard office equipment (i.e., computers, phones, and photocopiers).
• Required to work in hybrid office environment with two days in the Chicago office and three days work from home.

Disclaimers

• This job description reflects management’s assignment of essential functions; nothing in this document restricts management’s rights to assign or reassign duties and responsibilities to this job at any time.
• It is understood that a full-time exempt employee will generally work a minimum of 35 hours per week; however, in the scope of an exempt employee's normal job, work outside the usual schedule is often required. This might include evening meetings, weekends, limited travel, or work hours well beyond 35 in a given week.