- Works with leadership to evaluate maintain and enhance vendor relationships.
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- Collaborates with vendors and internal teams to develop prepare and analyze operational and performance reports including documenting submissions reviewing trends identifying outliers comparing data with the Health Funds Analytics team and recommending reporting and process improvements.
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- Meets regularly with vendors and internal teams to review performance monitor open items discuss trends and maintain effective working relationships.
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- Works with vendors and internal teams to resolve member issues in a timely manner track performance guarantees identify service deficiencies and develop and monitor corrective action plans as necessary.
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- Monitors vendor performance and ensures key oversight contractual and operational deliverables are met and maintained by both vendors and Health Fund staff.
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- Supports the Director Health Fund Operations in organizing quarterly and annual meetings by preparing agendas maintaining meeting minutes tracking action items following up on key deliverables and assisting with annual strategic planning activities.
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- Collaborates with the Director Health Fund Operations and vendors to identify and address issues arising from the day-to-day management of vendor relationships.
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- Reviews benefit administration issues and recommends process improvements operational enhancements and corrective actions as appropriate.
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- Identifies opportunities for benefit and service enhancements in partnership with vendors and internal stakeholders that support improved member outcomes and cost-management objectives.
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- Assists the Director Health Fund Operations in the design implementation testing validation and documentation of benefit changes.
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- Communicates directly with vendors verbally and in writing regarding operational issues plan administration matters and benefit-related questions.
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- Partners with Communications to inform Health Fund staff and members of health plan updates and benefit changes.
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- Communicates approved health plan modifications to vendors and coordinates implementation testing and validation of system updates including support for cross-functional implementation efforts.
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- Supervises assigned staff including establishing goals managing and prioritizing workloads providing coaching and feedback and supporting employee development.
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- Develops team members through performance and development plans focused on individual strengths and growth opportunities.
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- Maintains quality service to vendors and internal stakeholders by ensuring team performance standards and service expectations are met.
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- Oversees assigned projects including establishing deadlines coordinating resources assigning responsibilities monitoring progress and communicating project status.
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- Prepares reports and updates for management regarding project status risks and outcomes.
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- Identifies organizational dependencies to ensure project requirements are documented and implemented appropriately.
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- Serves as a liaison with vendors regarding project deliverables testing implementation activities and issue resolution.
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- Monitors vendor performance using service level agreements (SLAs) key performance indicators (KPIs) member experience metrics and contractual performance guarantees.
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- Partners with Communications to develop clear accessible communication materials that help members understand and utilize their benefits.
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- Performs other duties and special projects as assigned by management.
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