Request historical files from advisor or client, and review layout as needed.
Host the TPA implementation meetings.
Review data transmission process, file layouts, timing, etc..
Determine system hierarchy requirements and build in CRM.
Coordinate eligibility test files, updates, and production.
Coordinate claims extracts with all vendors (TPA, stop loss, advisor).
Coordinate ID card from TPA for approval.
Validate eligibility files and extracts post go live.
Conduit to the Navitus eligibility and claims extract teams.
Manage data sharing policies and Non-Disclosure Agreements with vendors.
Submit data and service requests, and ongoing monitoring to ensure accurate, timely completion.
Troubleshoot any vendor issues to ensure quick resolution, including support of the account teams in helping to facilitate resolution of escalated file issues.
Suggest and implement new vendor management processes, policies, and methods as needed.
Identify and research expansion opportunities, in addition to the growing the client base with existing consultant/broker/TPA relationships.
Other duties as assigned.
Requirements
Bachelor's degree in Business, Marketing, or related area preferred.
3 years of vendor management experience (TPA’s, Consultants, Brokers, etc.), and working with external clients preferred.
Knowledge of PBM or health care industry preferred.
PC skills such as Microsoft Office, Email, etc.
Participate in, adhere to, and support compliance program objectives.
The ability to consistently interact cooperatively and respectfully with other employees.
Benefits
Top of the industry benefits for Health, Dental, and Vision insurance
20 days paid time off
4 weeks paid parental leave
9 paid holidays
401K company match of up to 5%
No vesting requirement
Adoption Assistance Program
Flexible Spending Account
Educational Assistance Plan and Professional Membership assistance