Cambia Health Solutions, Inc.
Portland, OR, United States
Healthcare, Contract Management
Senior Benefit Contracts Analyst
This position can be in any Cambia location in Washington or Oregon.
The Senior Benefit Contracts Analyst is accountable for the development of Member enrollment materials (including, but not limited to, booklets, contracts and Summary of Benefit Changes (SBCs). Coordinates the filing of regulatory documents with the insurance division. Analyzes insurance division objections and organizes responses and resubmission functions. This position is primarily focused on dental and vision products.
At Cambia, our values are fundamental to achieving our Cause of transforming the health care industry. They guide our actions and bring diverse perspectives together to improve the health care journey better for those we serve. All eight values are equally important and linked to the others: Empathy, Hope, Courage, Trust, Commitment, Innovation, and Accountability. These values are not just words on paper - we live them every day.
Responsibilities & Requirements
The Senior Benefit Contracts Analyst would have a Bachelor's Degree in Healthcare, English, business or health care administration, communications or related field and 5 years of advanced work-related experience or equivalent combination of education and experience.
Must possess strong organizational skills with a demonstrated ability to prioritize, coordinate and implement multiple projects within varied or simultaneous time constraints.
Ability to coordinate activities with all levels of staff within the Plan and external agencies through clear and concise verbal and written communication skills, including tactful and persuasive negotiation skills.
Ability to work independently and exercise sound judgment while developing solid working relationships with internal and external business partners, including, but not limited to, Sales, Sales Operations, Product and the Insurance Division.
Ability to comprehend, master and draft all aspects of the Plan\u2019s contracts/booklets, benefits administration, and overall business processes for all lines of business/products including group specific or custom groups.
Demonstrated technical skills necessary to effectively navigate the electronic publishing system used for document creation.
Ability to work in high-pressure circumstances on multiple concurrent projects involving multidisciplinary, unconnected tasks, and proven ability to initiate and independently produce detailed and highly accurate work.
Knowledge of the health insurance industry, including benefit design and compliance issues with capability of incorporating into contracts and other related materials.
Experience/understanding and knowledge of federal laws and guidelines (including but not limited to COBRA, HIPAA, ERISA, USERRA, DOL. etc.) and applicable state insurance code and regulations, including the Affordable Care Act (ACA).
Ability to perform primary drafting functions on standard and custom filing projects including development of contract language.
Proficiency in all complexity levels of custom group drafting and filing, including development of contract language.
Ability to step in to a lead role in the absence of a BCA lead.
Participation in product implementation.
Assist the Manager, Supervisor and Lead in the training and development of other team members and providing advanced support of all team functions.
Support the Lead & Supervisor in establishing team training needs, guidelines and materials and identifying procedures and systems requiring quality or process improvement and designing and implementing such revisions.
At Cambia, we advocate for transforming the health care system. You aren\u2019t satisfied with the status quo and neither are we. We're looking for individuals who are as passionate as we are about transforming the way people experience health care. We offer a competitive salary and a generous benefits package. We are an equal opportunity employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A drug screen and background check is required.
Cambia\u2019s portfolio of companies spans health care information technology and software development; retail health care; health insurance plans that carry the Blue Cross and Blue Shield brands; pharmacy benefit management; life, disability, dental, vision and other lines of protection; alternative solutions to health care access; and free-standing health and wellness solutions.
We have over a century of experience in developing and providing health solutions to serve our members. We had our beginnings in the logging communities of the Pacific Northwest as innovators in helping workers afford health care. That pioneering spirit has kept us at the forefront as we build new avenues to improve access to and quality of health care for the future.
Cambia Health Solutions, Inc.
Website : http://www.cambiahealth.com/
Since then, Cambia and its companies have been on a continuous journey, creating and investing in innovations designed to serve the changing needs of individuals and families in our communities and beyond. This includes nurturing and growing our wide range of Direct Health Solutions companies, as well as providing the best care possible with our Health Insurance Services companies, which insure more than 2 million people in four states.