Insurance Program Manager

Where

Eden Prairie, MN

What you'll be doing

Assist in securing new insurance contracts. Serve as a subject matter expert on CMS requirements, including the tracking of benefit changes through this process. Lead the evaluation and recommendation of appropriate platforms or systems to support insurance contract programs. Assist in the design and development of systems to effectively manage database of contracts and details of claims and payments. Design benefit programs by examining, evaluating, and understanding regulatory requirements, compliance and competitive advantage. Conduct annual review in the claims processing system to ensure that benefits have been configured accurately and meet expected results. Develop internal team training and process documentation for all insurance contracts. Develop training materials and trains business owners (key accounts) on insurance contract processes. Serve as subject matter expert on benefits for all member materials, including the annual compliance requirements. Review, update and develop new benefit interpretation policies, as necessary. Serve as subject matter expert related to benefit oversight and conducts annual and ongoing training to all internal stakeholders, including but not limited to, customer service, sales, and claims.

What your background should be

Minimum 4 years of experience in a directly related field. Advanced proficiency in MS Office suite of products. Knowledge of insurance standard codes. Advanced knowledge in healthcare benefits, benefit administration and health care delivery.

Required Schooling / Training

Bachelor's degree in business or health care administration, or other related field.

Who is the client company

A world leader in the design, development and distribution of comprehensive hearing solutions.
If you are interested in this position, send your resume to apply@kochdavis.com