Contract Services Supervisor - Internal Applicants Only

Lets do great things together!

About Moda
Founded in Oregon in 1955 Moda is proud to be a company of real people committed to quality. Today like then were focused on building a better future for healthcare. That starts by offering outstanding coverage to our members compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Lets be better together.

Position Summary
Supervises Contract Services staff with production of standard non-standard and moderate complexity manuscripted plan documents for all company lines of business development and production of plan change forms and Summaries of Benefit and Coverage (SBCs). Assists with contract product directly with a designated set of assigned contracts. Supports company initiatives and completes special projects in compressed timeframes following strict turnaround time requirements; provides ad hoc reports as needed.

Pay Range
$70579.27- $88224.08(depending on experience)
*Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.

Please fill out an application on our company page linked below to be considered for this position.

Dental Vision Pharmacy Life & Disability

Required Skills Experience & Education:

1. Undergraduate degree or combination of college level course work and industry experience.
2. Minimum of 2 year experience as a Contract Specialist or comparable industry experience with a preference for health insurance experience in a technical area such as regulatory contracts or claims processing.
3. Demonstrated proficiency using Adobe and Microsoft Office applications including Word and Excel.
4. Demonstrated personnel management ability
5. Ability to research and locate information in Facets and other systems available to the Department.
6. Proficiency in computer keyboard minimum typing ability of 35 wpm.
7. Effective verbal written and interpersonal communication skills.
8. Demonstrated ability to identify problems and initiate a solution.
9. Ability to initiate and to follow departmental policies and procedures.
10. Ability to work under pressure and exhibit flexibility in changing priorities.
11. Ability to learn new information and apply it to a variety of situations.
12. Highly effective organizational skills with the ability to prioritize and meet deadlines.
13. Maintain confidentiality and project a professional business image to internal and external customers.
14. Ability to work on time and on a daily basis.

Primary Functions:

1. Performs performance reviews and conducts all supervisory duties for staff including disciplinary action as needed
2. Supervise staff to ensure accurate and timely preparation and completion of plan documents including policies administrative service agreements member handbooks endorsements and plan change forms for new and renewing standard non-standard and manuscripted groups for all company lines of business
3. Develop an understanding of company products and how they relate to plan documents and stay current on changes to existing products and new products. Train staff on these subject matter areas.
4. Communicate with internal departments both verbally and in writing on various issues such as changes requested by groups verification of benefits changes made to drafts and final products after delivered to other departments. Train and oversee staff to do same.
5. Develop an understanding of regulatory requirements identify potential regulatory questions and concerns and refers inquiries related to regulatory functions to the Regulatory team. Develop training for staff to support same.
6. Ensure that team organizes its work in an orderly fashion such that the team produces reports and maintains accurate group files and work logs as needed.
7. Identify discrepancies between contract templates and regulatory filings and brings forward suggestions for future filing changes. Train staff to do same.
8. Identify policy and handbook improvement ideas and forwards to the Regulatory team. Train staff to do same.
9. Maintain a professional and helpful attitude to handle internal and external inquiries requests and changes
10. Perform other duties as assigned

Working Conditions & Contact with Others

• Office environment with extensive close PC and keyboard work constant sitting and phone work. Must be able to navigate multiple screens. Work in excess of 37.5 hours per week during peak business periods.

• Internally with all levels of staff and management including Medical/Dental Claims and Customer Service Benefit Configuration Pharmacy Services Regulatory Underwriting Sales Billing and Eligibility Business Implementation Unit and Accounting. As needed externally corresponding with brokers producers consultants and group administrators through Sales.

Together we can be more. We can be better.

Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race religion color age sex sexual orientation national origin marital status disability veteran status or any other status protected by law. This is applicable to all terms and conditions of employment including recruiting hiring placement promotion termination layoff recall transfer leaves of absences compensation and training.

For more information regarding accommodations please direct your questions to Kristy Nehler & Danielle Baker via our email.

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