ProMedica Looking for Marketplace Product Specialist – Operations – Paramount -Remote at Remote Full Time

Job type full-time

Benefits pulled from the full job description

Dental insurance health insurance vision insurance

Not provided by employer

Full job description

Promedica’s health plan, paramount insurance, offers health insurance products across six midwest statesParamount is an ohio-based health insurance company, headquartered in toledoThe organization has more than 800 employees dedicated to serving their health plan members.

Paramount offers medicare advantage and marketplace exchange health plans for individuals and familiesParamount maintains accreditation by the national committee for quality assurance (ncqa) for their hmo and medicare advantage products.

In addition, paramount has a full complement of insurance products for employers of any size, including medical, dental, vision and workers’ compensation, as well as vocational rehabilitation, life-care planning and wellness.

As a part of promedica, paramount is driven by promedica’s mission to improve your health and well-beingPromedica has been nationally recognized for its advocacy programs and efforts to address social determinants of healthParamount strives to provide an exceptional experience to every memberFor more information about paramount, please visit our websiteHttp://www.paramounthealthcare.com.

Position summary:

Responsible for being the product subject matter expert and oversight of all marketplace qualified health (qhp) and dental (qdp) products and vendorsThis responsibility includes business level review of all applicable regulations, cciio requirements, annual application and filing processesThis position will also assist applicable departments with claims configuration, product training and education of key departmental personnel.

Accountabilities:

Coordinate annual product form, rate and template filings and application process.
Assist with product design and expansion efforts.
Support corporate, state and federal compliance initiatives, including maintenance of administrative compliance documents, procedural manuals and audit data compilation relative to the marketplace.
Serve as a marketplace segment point of contact for internal and external regulatory issues and inquiries and represent company at meetings as necessary.
Work with it department and marketplaces to coordinate all testing requirements.
Complete internal tracking reports and assist in directing marketplace efforts within the promedica marketing and communications, risk adjustment, quality, member services, its, underwriting/actuary, finance, and membership departmentsAssisting these departments in coordination of all annual, monthly and periodic mailings, including member letters regarding benefit changesAssist with the design of forms, flyers, presentations or other types of external communication as necessary.
Lead collaboration with member services, sales and promedica marketing and communications to develop a plan to maximize profitability, growth and retention effortsMonitor and report on the plan.
Cooperate, as needed, intradepartmentally as well as interdepartmentally, and perform all other duties as assigned to support the overall operations for marketplace product.
Assist with non-marketplace project management roles as necessary, to broaden global paramount product line knowledge and awareness.
Management of all vendors that support qhp and qdp products.
Assist with external compliance audits.
Remain current on compliance requirements and upcoming changes for assigned line of business.

Required qualifications:

Education: bachelor’s degree in a business, health care administration or any other field as appropriate.

Skills:

Demonstrated planning, organizational and problem solving skills required, with the ability to handle multiple priorities and to work independently
Excellent communication (oral, written & interpersonal) skills

Experience with all microsoft applications

Years of experience: prior experience of marketplace is preferred.

Promedica is a mission-based, not-for-profit integrated healthcare organizational headquartered in toledo, ohioFor more information, please visit www.promedica.org/about-promedica

Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected categoryIn compliance with the americans with disabilities act amendment act (adaaa), if you have a disability and would like to request an accommodation in order to apply for a job with promedica, please contact [email protected]

Equal opportunity employer/drug-free workplace

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Posted 30+ days ago