JOB DESCRIPTION SUMMARY
The Supervisor, Benefit Distribution and Installation, reports to the Director of Administration. This position is responsible for supervising the staff, policies, and procedures for both Western Growers Assurance Trust's (WGAT) and Pinnacle Claims Management Inc (PCMI) in the area of new business installation, plan changes, and rate changes/renewals. The role oversees the Installation, Plan Coding/Testing, and Group Setup departments, ensuring accurate processing, compliance, and set up for health plan participants and employers. Additionally, the supervisor manages a team dedicated to ensuring smooth implementation processes and operational efficiency.
DUTIES AND RESPONSIBILITIES
Implementation Supervision/Support
- Manage the implementation of all new business with WGAT clients, with necessary communication with sale and outside brokers. Oversee screening, review and processing of all new business, plan change, and renewal paperwork for compliance purposes to include completeness, required forms, accuracy and content.
- Oversee the implementation of each new client with the third party administratorion (TPA) client, with necessary communication between the broker, PCMI operational areas, the client and any external vendor as necessary, including the review, completion & sign-off on Client Set-up Sheetsforms/screens.
- Lead staff in area of installation analysis and audit review for all new client submissions of WGAT and PCMI.
- Supervise staff in area of benefit plan coding and testing to ensure accurate plan coding of medical, dental, vision, and other plans types for WGAT and PCMI.
- Preside over company, group, member, and rate setup to ensure accurate HCPS system coding and invoicing for WGAT and PCMI.
- Train and supervise staff in department policies and procedures as necessary to maintain department and organizational standards and strategic objectives.
- Coordinate and delegate special projects as they arise in the area implementation and plan coding
Coordination of Cross Functional Teams
- Interface with personnel in all field offices, TPA employers and brokers, and management staff as necessary to communicate any problems or issues with paperwork submission or installation issues for new business, plan changes, rate renewals and rate changes.
- Communicate with other operational departments as necessary to ensure smooth integration on installation of WGAT and PCMI new business, plan changes, rate changes/renewals, to meet strategic objectives of the organization.
- Manage a cross-functional work team during the flow of new business, rate changes, plan changes and plan additions across all operational areas for both the Trust and TPA business. Attend weekly operations meeting and communicate any issues / events for dissemination to all areas of organization.
- Provide weekly management reports to leadership
Management & Leadership
- Develop, manage, and lead a team of 3A+ self-accountable professionals.
- Develop a culture of real, personal accountability by modeling the behavior that defines it.
- Instill a culture of safety and expectation, within your respective area/s.
- Require direct reports to hold themselves accountable to high standards of performance and personal conduct, in a clear, helpful, straightforward way.
- Conduct one-on-one conversations with every direct report, quarterly, focused on their 3A+ capabilities, impact, and effort.
- Make decisions and choices, impacting staff, by using the steps as outlined in the "Outward Mindset Skills for Leaders" guide.
Other
- Utilize all capabilities to satisfy one mission - to enhance the competitiveness and profitability of our members. Do everything possible to help members succeed by being curious and striving to understand what others are trying to achieve, planning, and executing work helpfully and collaboratively. Be willing to adjust efforts to ensure that work and attitude are helpful to others, being self-accountable, creating a positive impact, and being diligent in delivering results.
- Maintain a clean DMV record and the ability to travel to locations throughout the U.S. (mainly California and Arizona) up to 5% of the time.
- All other duties as assigned
PHYSICAL DEMANDS/WORKENVIRONMENT
The physical demands and work environment described here are representative of those that must be met by an employee to perform the essential functions of this job successfully. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to communicate with others. The employee frequently is required to move around the office. The employee is often required to use tools, objects, and controls. This noise level in the work environment is usually moderate.