Client Administrator II

Client Administrator II

$50,667 - $66,500 - $82,333

"Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate."

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

The Scoop:

This position is responsible for leading and managing all Contact Center aspects of servicing clients. Ensures client satisfaction throughout plan implementation, post implementation and all other related service activities and strategic projects on behalf of the Contact Center. Accountable for meeting client service commitments for multiple plan designs including Medicaid, Market Place, and Medicare Part D. Serves as a point of contact for assigned clients, Client Service Management, Implementation, Benefits Management, and other departments to achieve service commitments and improve business processes, and increase company profitability. This position is responsible for tasks that are complex in nature where considerable judgment and initiative are required in resolving problems and making decisions and/or recommendations. The Client Administrator II is ultimately responsible for ensuring consistent customer satisfaction, delivering successful projects and building and maintaining solid business relationships with regards to the Contact Center.

What You Get To Do: include the following. Other duties may be assigned.

• Serve as first point of contact for clients for all Contact Center related requests and problem resolution
• Responsible for all aspects of service for assigned book of business including member, pharmacy, physician, and client requests
• Operates as the liaison between multiple business areas as needed in researching and resolving client specific issues, implementing process changes and new products, and training all staff members
• Develops and maintains excellent working relationships with clients and establishes themselves as an active part of the client team
• Partners with various departments such as Configuration Services, Accounting, Pharmacy Networks, GPS and Client Service Managers to ensure that the clients receive timely responses and that all Sales Force cases are handled in a timely fashion
• Stay current with and apply CMS requirements for Medicare Part D call center activities and understand how the company manages these regulations and the processes within different departments
• Provide consultation and recommendations for clients regarding the regulations and ensure all Contact Center processes provide high quality and compliant customer service
• Ensures appropriate levels of service and operational support to assigned clients by understanding and championing clients' operating requirements throughout the organization to ensure mutual success
• Facilitate solution development efforts and make decisions regarding solutions in order to effectively manage Contact Center service improvements in service and technology
• Develop and implement strategic project planning that provides mutual performance objectives
• Track projects and issues closely, foster collaboration from both the business and technology groups and lead issue resolution meetings during a project
• Create realistic plans and forecasts related to customer performance
• Communicate status reports for management, clients and the project team, and meet with project personnel to provide technical recommendations to resolve problems
• Facilitate regular project status meetings to assess progress versus milestones, and identify areas of potential concern in order to mitigate risk as well as provide updates to Management
• Assume responsibility for delivery by ensuring all Contact Center components of the project are successfully completed, assist with training of staff regarding project/product output, development of supporting materials, or documentation and client interface
• Completes special projects (such as leading workgroups, overseeing projects, development of new system functionality, mentoring/training staff, etc.)
• Define Contact Center processes and implement call reduction strategies
• Negotiate and seek agreement with clients regarding the need for process changes
• Recommend alternative solutions to suggested benefit changes in order to reduce calls in the Contact Center and disruptions to claims processing
• Develop, maintain, and modify Contact Center processes when the clients' requirements change
• Ensure system notes are updated, and develop and conduct training for contact center staff
• Analyze and track the impact of process changes on call volume and make adjustments as needed
• Fully understands and can effectively articulate the plan designs and benefit setups for their clients and be involved in the claims testing process
• Partner with the client and the implementation teams in reviewing the test claim results and makes recommendations regarding potential solutions
• Develop and manage staff training for new products and clients. Includes organizing training groups, develop training documents and job aids
• Facilitate train-the-trainer sessions and transition training information to the Quality Team
• Analyze data to improve strategic decision making and implementation
• Track and identify trends regarding the impact of new client/benefit implementations on call types, source, reason, and volume
• Analyze the future impact (call volume for forecasting purposes) of new implementations based on call types
• Leads the implementation process for the onboarding of new business and new groups for existing clients for the Contact Center
• This includes timely and accurate drafting, documentation, and sign off of the Customer Service Procedures, Claims Internal Procedures, and other related documents
• Communicates client commitments and expectations to internal partners, interpreting and providing context for client Contact Center requests, hosting meetings and conference calls, coordinating client toll-free number assignment and set-up, Claims and Subrogation letter set-up
• Creates Pharmacy Broadcast and other related documents to ensure impeccable implementations to minimize member disruption and Contact Center impacts
• Effectively educates the client on Contact Center processes to ensure that the client is fully oriented
• Provide Call Center Metrics and responses for Request for Proposals
• Attend "Sales to Implementation (S2I)" meetings and determine impact of new business on the Contact Center
• Operationalize commitments made to the client and partner with clients to determine how to best service the business (i.e., member calls, offshore, afterhours, DMR and member communication)
• Ensure Performance Guarantees are achieved by reviewing reports and analyzing data
• Review Performance Guarantee reports each month to confirm client specific metrics are met as described in the contract
• Analyze business process flows to identify opportunities to recommend internal process improvements in coordination with other departments
• Ensure timely and accurate documentation of notes and procedures in MedAccess and other proprietary systems
• Travel to client's location for new implementations and open enrollments, deliver on-site training, and serve as a subject matter expert at client benefits fairs
• Creates and facilitates yearly Part D compliance training to support CMS guidance
• Able to facilitate new CSR training including the delivery of initial two-week training class and subsequent follow up sessions during the first two weeks on the floor

Supervisory Responsibilities

This job has no supervisory responsibilities.

Education and/or Experience

For consideration candidates will need:

• A bachelor's degree (B.A.) from four-year College or university; or three (3) to five (5) years related experience and/or training; or equivalent combination of education and experience
• At least two (2) plus years' experience with Project Management or Project Coordination using best practices for project methodology, preferably in a healthcare, Pharmacy Benefit Management (PBM), managed healthcare service organization, insurance company, or other health related entity
• Must be familiar with healthcare related state and government regulations such as Medicaid, Medicare and CMS
• Previous experience interacting with clients and customers, including accountability for achieving service commitments and resolving complaints is required

Computer Skills

Intermediate knowledge of Microsoft Office Suite Word Processing software, MS Project, and Visio software. Experience with Windows based database programs is also required. Knowledge of healthcare operating systems in PBM industry preferred.

Certificates, Licenses, Registrations

Pharmacy Technician Certification preferred.

Other Skills and Abilities

• Detailed understanding of claim processing concepts, experience with Medicare Programs and enrollment and claim adjudication preferred
• Ability to prioritize urgent issues effectively and ability to effectively balance a high volume of work
• Detail oriented with a high degree of accuracy & follow through
• Self-starter with the ability to work independently and as part of a team
• Must possess the ability to effectively communicate proposed design solutions in a consultative manner and provide input and guidance in a way that fosters understanding amount internal partners and clients
• Excellent problem resolution, team building, judgment and decision making skills required

Travel

This position requires limited domestic travel and attendance maybe required at various local training sessions and/or meetings.

The Perks:

• Medical / Dental / Vision / Wellness Programs
• Paid Time Off / Company Paid Holidays
• 401K with Company match
• Life and Disability Insurance
• Tuition Reimbursement
• Employee Referral Bonus

This position is eligible for Employee Referral Bonus at Level I

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers

MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer, Male/Female/Disabilities/Veterans

OSHA/ADA:

To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer:

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.