Summary
Job Summary
Responsible for managing the day-to-day functions of the TPA Department which includes assessing, planning, developing, implementing, coordinating, and evaluating the TPA benefit plan. Develops and maintains relationships with Preferred Administrators’ new and existing client base. Ensures continuous department workflow, effective and efficient communication with internal departments, and provides training, guidance and professional and technical development for the department team members. Oversees the TPA department to ensure that Associates meet performance goals, benchmarks, and handles issue resolution with client(s), members and provider community with overall customer service satisfaction.
Skills
1. Excellent bilingual oral/written skills in English and Spanish.
2. Demonstrates exceptional communication and presentation skills.
3. Excellent interpersonal skills.
4. Strong knowledge of Microsoft Excel and Access programs.
5. Performs the basic functions or arithmetic; add, subtract, multiply, and divide all units of measure. Computes ratio and percent. Created and interpret bar graphs.
6. Performs reading, writing, and speaking at all intermediate level, demonstrating good oral and written communication skills as well as attention detail.
7. Strong organization, leadership, and customer relations skills required for effective communication with members, physicians, public, staff and administration.
8. Ability to exercise good judgment, tact and diplomacy in all public and private dealings.
9. Strong background in health insurance and employee benefits.
Work Experience
Three years of supervisory/management experience is required. Strong background in benefit administration for third party/commercial and/or managed health care is required.
License/Registration/Certification
None
Education and Training
Bachelor degree in Business, Health Science, or related field is required.