Employment Spot

Job Description

The 1199SEIU Benefit & Pension Funds provide comprehensive health, pension, and quality of life benefits to health care unionized workers represented by 1199SEIU United Healthcare Workers East.  We are among the largest labor-management funds in the nation, covering 430,000 members and their families.

If you’re ready for the brightest career future, join us in this excellent opportunity to showcase your talents.  We are currently seeking an experienced Associate Director (Healthcare Eligibility & Enrollment) for our Eligibility department. 

Responsibilities: 

• Assist the Director in the overall management of the Eligibility department which validates and processes enrollment and eligibility data for all 1199SEIU Members that apply for healthcare and other benefits (pension, childcare, training, etc) ; the department also updates and maintains member data in Enrollment Processing System, activates prescription benefits through Medco eligibility system, and conducts other related functions
• Assist in the development, implementation and enforcement of Fund policies and procedures as they relate to member eligibility, Summary Plan Descriptions 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 and monthly cost center budgets
• Review and monitor quality control reports to ensure the integrity of eligibility data and monitor benefit suspensions; analyze membership data information as reported by eligibility system, make recommendations for improvement based on trends, business best practices and incorporate good checks and balances
• Assist in the implementation of new eligibility and enrollment system (Vitech-V3); appropriately address systematic discrepancies, testing, upgrades, data conversions and effectively meet project time-lines
• Oversee Eligibility department, supervise management and staff; hire, train, and evaluate performance in accordance with Human Resources guidelines, procedures, and provisions of Collective Bargaining Agreement
• Conduct strategic planning sessions with management to analyze department operations, work flows 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 member enrollment process
• Complete additional projects and responsibilities as assigned

Job Requirements

• Bachelor’s Degree in Business Management, Health Administration, or equivalent years of experience required;  plus
• Minimum eight (8) years experience managing Healthcare Eligibility and Enrollment for large organizations in a Health Insurance or benefits environment required; or eight (8) years Quality Assurance, Healthcare Operations or Benefits Administration experience
• Minimum of five (5) years supervisory experience working with a large staff (exempt and non-exempt) staff maintaining production and quality standards
• Experience in pension or union environments highly preferred
• Proficiency in Microsoft Excel, Access, and Power Point
• Experience managing multiple projects under strict time-lines and meeting overall 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
• Excellent communication skills both verbal and written; superb interpersonal skills professional attire and presentation a must
• Ability to work evenings and weekends as needed
• Must meet performance standards including attendance and punctuality

We offer a competitive salary, an excellent fully employer-paid comprehensive benefits package and talented professional colleagues. For consideration, please visit us at http://www.1199seiubenefits.org/ and click on the “Jobs" link. Please mention you saw this ad in Career Builder. We are an Equal Opportunity Employer.