Job Description

Department Preferences

• Advanced technical abilities, including expert level Excel skills
• Experience with membership reporting preferred
• Experience creating dashboards and pivot tables within Excel strongly preferred
• Experience with Salesforce preferred

Obtain and analyze program specifications to develop contract language, proposal summaries and benefit comparisons relating to major accounts. Coordinate implementation of new group and/or group wide changes with appropriate programs.

• Analyze, investigate, formulate, develop and initiate system changes to improve quality, processing time, and efficiency and benefit accuracy.
• Coordinate and draft all customized and standard proposal components.
• Coordinate account specific maintenance requests and maintains appropriate tracking logs.
• Provide technical expertise related to proposal development, finalization and sales presentations to sell and promote new or modified BCBSM programs.
• Attend meetings with internal and external staff, answering questions and providing requested benefit and systems information.
• Lead workgroup meetings composed of claims systems personnel, operations and other corporate areas to ensure customer expectations are met.
• Conduct feasibility surveys to determine program delivery capability.
• Interact with business consultants and account management, primarily in the state of Michigan.
• Resolve issues raised by the account concerning administration of the group's health care program.
• Participate in system testing, develop procedures and/or controls and provide recommendations for the ongoing improvement of processes.
• Develop and maintain an effective working relationship with account and/or service management, customers and programs.

"Qualifications"

• Bachelor's Degree in Business Administration, Computer Science, Health Care Administration, Marketing or related field preferred.
• Three (3) to five (5) years related experience in Customer Relations, Operations and/or Product Development.
• In depth technical knowledge of all benefits, rating, underwriting, enrollment, administrative, delivery mechanism, policies and procedures related to sales and marketing programs.
• In depth technical knowledge of quality control mechanisms, applications and systems.
• Extensive knowledge of BCBSM and/or BCN operations.
• Excellent analytical, decision-making, organizational, planning, verbal and written communications skills.
• Possess tact and resourcefulness in establishing and maintaining effective internal and external working relationships.
• Knowledge of claims processing techniques as well as system analysis and design.
• Proficient in current industry standard PC applications and systems.
• Strong background in various corporate areas such as benefits, claims processing/inquiry training, cost containment, marketing and systems.
• Valid Michigan driver's license required.
• Travel to business locations as required.
• Other related skills/and or abilities may be required to perform this job.

All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.