Account Manager I

Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, click here.

Job Summary

This role develops and maintains strong relationships with THP’s clients, brokers and consultants while focusing on strategic planning for each account in order to retain and increase membership; meet revenue goals; and introduce new products and benefits as appropriate. This is accomplished through the execution of the service model for Retiree Sales which includes renewal of accounts, enrollment of new members aging into Medicare and during annual enrollment and handling escalated service issues in a timely and highly effective manner. This role understands the customer and the competitive landscape, and supports efforts to identify customer needs, gather competitive information and test product and service ideas.

Key Responsibilities/Duties – what you will be doing

KEY RESPONSIBILITIES/ESSENTIAL FUNCTIONS* (in order of importance)

% of TIME

(Optional)

• Provides consultative service to clients and brokers. Effectively manages renewal activities including understanding client and broker objectives and providing creative solutions to meet objectives.
• Negotiates all aspects of the renewal including plan design, product selection, underwriting (ratings, methodologies, formulas /calculations), and funding arrangements to deliver satisfactory results for both client and THP
• Manages the clients’ open enrollment activities, oversees the administrative aspects of the renewal process including communications and RFP management, ensuring all internal processes are complete and accurate

• Builds and maintains strategic relationships with clients, brokers, and consultants through meetings, calls, emails, and by meeting expectations for account management and service results. Works with client and broker to enhance products and benefits offered to build value and grow membership.

• Oversees eligibility and enrollment process in adherence with CMS Compliance requirements.

• Develops and tailors presentation decks and conducts meetings appropriate for the market segment

• Assists in setting strategic direction for requests for proposals (RFP), collaborates with RFP team, responsible for executive summary, final review and sign-off (as needed)

• Educates customers and brokers on THP’s value prop, capabilities and organizational objectives

• Partners with support staff and other internal teams to resolve problems and issues to ensure THP provides outstanding service to all constituents and internal work teams – Claims, Enrollment, Premium Billing, Member Services.

• Ensures health fair coverage and management of client’s open enrollment requirements

• Provides employer group and broker feedback to leadership in order to improve value proposition for specific market segments

• Maintains account files and records and maintains appropriate documentation on all service activities
• Completes weekly and monthly reports
• Identifies accounts at risk
• Obtains and communicates competitor information
• Assists in covering health fairs or presentations of other client services staff
• Attends staff meetings, assists in training new staff
• Identifies new ways to provide added value to customers and THP

Qualifications – what you need to perform the job

JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES

EDUCATION: (Minimum education & certifications required)

• BA/BS degree required

EXPERIENCE: (Years of experience)

• Prior business experience required as well a minimum of 4 years successful experience in health insurance and/or managed care in a client service or sales role
• Complete understanding of fully and self-insured plans, funding arrangements and reinsurance
• Good understanding of local and national markets, competitive environment, and industry trends
• Good understanding of regulatory, legislative, and political environment as it impacts THP and customers

SKILL REQUIREMENTS: (Include interpersonal skills)

• Applies technical expertise to address complex client issues and questions
• Full understanding of and the ability to analyze and interpret THP underwriting data and methodologies
• Full understanding of THP’s clinical programs and the application / impact to clients
• Strong presentation and meeting management skills required
• Ability to present and communicate information with equal effectiveness to both the wholesale and retail client audience
• Advanced negotiation and influencing skills
• Strong organization skills
• Ability to interact with confidence with all levels of THP, including Senior Leadership
• Timely and accurate record keeping of complex account activity
• Health Insurance Producer’s License required

WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS: (include special requirements, e.g., lifting, travel, overtime)

• Works 60% of the time in the office, 40% on the road. Travel necessary and ability to obtain transportation required. Job may require early morning, evening or week-end hours. Occasional travel to corporate headquarters of accounts located outside Massachusetts may be necessary.

CONFIDENTIAL DATA: All information (written, verbal, electronic, etc.) that an employee encounters while working at Tufts Health Plan is considered confidential. Exposed to and required to deal with highly confidential and sensitive material and must adhere to corporate compliance policy, department guidelines/policies and all applicable laws and regulations at all times.

Compensation & Total Rewards Overview

Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity

​Point32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do—from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.