Senior Sponsorship Specialist

Company: Washington Health Benefit Exchange
Location: Olympia
Posted on: May 24, 2023

Job Description:

The Washington Health Benefit Exchange is a public-private partnership that operates the WAPlanfinder mobile app and Washington Healthplanfinder, the eligibility and enrollment portal used by one in four Washington residents to obtain health and dental coverage. Through Washington Healthplanfinder, individuals and families can compare and enroll in health insurance coverage and gain access to financial help and public programs like Washington Apple Health.The mission of the Exchange, a state-based marketplace, is to radically improve how Washington residents secure health insurance through innovative and practical solutions, an easy-to-use customer experience, our values of integrity, respect, equity and transparency, and by providing undeniable value to the health care community.The Exchange is also committed to identify and reach groups at risk for obstacles to access coverage, which includes supporting those who need assistance overcoming barriers to seek, find, and use their health insurance coverage. Specifically, the Exchange is embracing the following equity statement:Equity is a fundamental pillar to the society we seek to build. The process of advancing toward equity will be disruptive and demands vigilance, dismantling deeply entrenched systems of privilege and oppression. We must focus our efforts on people and places where needs are greatest, especially communities of color, and go beyond remedying a particular inequity to address all determinants of health.Our goal is that all Washingtonians have full and equal access to opportunities, power and resources to achieve their full potential.SUMMARYSponsored enrollments result from a unique and complex interplay of customer, analyst, carrier and sponsor actions. Sponsorships are maintained through coordination of insurance carriers, the Exchange, and sponsor organizations. This role will be responsible for processing the enrollment life cycle of sponsored enrollments through Washington Health Benefit Exchange using Edifecs and the Healthplanfinder System and perform comprehensive analysis and reconciliation to ensure accuracy. This position also provides subject matter expertise and support to insurance carriers, sponsor organizations, and internal teams, and supports program integrity and improvement efforts by building and maintaining relationships with sponsor organizations and insurance carriers, developing, and documenting processes, and informing business requirements for system enhancements.DUTIES AND RESPONSIBILITIES* Serve as a subject matter expert on sponsorship, including:o Relevant federal, state, and Exchange policies and regulationso Comprehensive knowledge and understanding of the major tracks pertaining to sponsorship (i.e. eligibility, enrollment, reconciliation, finance, enrollment data interface (EDI), etc.)o Deep understanding of the end-to-end sponsorship process from the perspective of the sponsored enrollee, sponsor, carrier, and Exchange* Process weekly and monthly reconciliation reports from and for sponsors, carriers, and Exchange teams to support accurate sponsored enrollments and premium payments* Monitor and analyze sponsor data in monthly carrier Full Carrier Audit (FCA); coordinate with Enrollment Analysts and carriers to resolve discrepancies on sponsored enrollments and sponsorship status* Provide comprehensive analysis and reconciliation of sponsorship, enrollment, and payment data via HealthplanFinder and Edifecs* Build and maintain strong working relationships with sponsors, carriers, and Exchange teams by participating in meetings, responding to phone calls and emails, conducting on-site visits, reviewing ad-hoc reports, and responding to escalated/urgent issues.* Coordinate sponsorship onboarding for new sponsors, new carriers, and between the sponsor and the carrier.* Attend and support quarterly Sponsorship meeting* Provide training to sponsorship organizations to support client enrollment and sponsorship reconciliation.* Collaborate with departmental subject matter experts to meet the needs of sponsored Healthplanfinder clients quickly and accurately* Collaborate with Data and Reporting Team to ensure accurate reporting of sponsored enrollments* Collaborate with Finance Team to ensure accurate payment for enrollments sponsored through the Exchange* Respond to urgent sponsor requests, executive escalations, and escalations from government entities* Provide in-depth case analysis and recommended resolutions, including data fix suggestions that meet the needs of business and IT* Maintain confidential sponsorship lists, client records, statistical data, and tracking information; submit required reporting information in a complete, accurate and timely manner* Support the development and maintenance of program documentation, including the Sponsorship Guide, Handbook, and relevant business processes* Open and support special enrollment periods for sponsorship as needed, assign sponsorship in HealthPlanFinder, and maintain customer enrollments, as requested* Participate in process improvement groups and Healthplanfinder enhancements within Operations.* Support Sponsorship Manager as a backup, as needed, upon request
QUALIFICATIONSRequired:* Bachelor's degree and three years of experience in:o Enrollment and reconciliation processing; ando Assisting clients with complex issues and service needs in a social service, healthcare, or health insurance setting.o Additional qualifying experience may substitute, year for year, for education.* Demonstrated mastery of required enrollment-related systems and at least one year of experience as an analyst in a reconciliation or enrollment setting.* Ability to maintain high level of confidentiality. * Demonstrated ability to earn the trust, respect, and confidence of co-workers, carriers, sponsors, and customers through consistent honesty, forthrightness, responsibility, and professionalism in all interactions.* Strong interpersonal skills; ability to work with diverse client populations, as well as all levels of internal management and staff.* Excellent written and verbal communication skills with the ability to communicate effectively regarding complex or sensitive information or issues.* High attention to detail, able to successfully follow detailed instructions, motivated to take initiative and "read between the lines" if needed, and willing/able to ask questions when discrepancies are identified or when your work does not appear to align with WAHBE mission/vision/values.* Proficient in MS Office, specifically MS Excel
Desired:* At least one year of experience interfacing with sponsor organizations and/or as the designated lead enrollment analyst for insurance carriers.* Experience working in the public sector.* Broad knowledge and understanding of the health care industry, including the commercial insurance market, Medicaid, or other health delivery systems. * Motivated self-starter with initiative to take independent action and accept responsibility for your actions. * Well organized, flexible, proactive, resourceful and efficient with strong attention to detail.* Integral and comprehensive understanding of sponsorship work and its impact on partnering teams' work at HBE, such as Enrollment, Eligibility, and Carrier Operations.
APPLICATION INSTRUCTIONSThis position will be open until we find a suitable number of candidates to review. If interested, please submit an application as soon as possible. The Exchange reserves the right to close the recruitment at any time. SALARY INFORMATIONThe posted salary is the full salary range. The range of consideration for new hires is from $55,352.00 - $69,190.00. Offer will depend on qualifications.BENEFITSTake a peek of our .WORKING CONDITIONSCore business hours are 8:00 a.m. to 5:00 p.m., Monday through Friday. Travel requirements will be limited to local travel, however there may be occasions were an employee is required to travel and work irregular hours to attend meetings or trainings. Duties of this position require the use of standard office furniture and equipment (e.g. desk, filing cabinet, computer, printer, telephone, fax machine, copy machine, etc.). The working conditions and physical demands are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.In alignment with the Governor's proclamation and WAHBE's duty to provide and maintain a safe work environment free of known hazards, to reduce business and community disruption associated with COVID-19 surges, and to reduce the risk to the public we serve, all employees must provide evidence that they have received the COVID-19 vaccination in full as a condition of employment, or have received an approved medical or religious exemption. SPECIAL REQUIREMENTSA criminal background screen will be conducted for candidates under final consideration, and if hired, every five years of employment where highly sensitive data is processed or maintained by the position. The result of this background screen must meet the Exchange's eligibility standards. OTHER INFORMATIONThe above statements are intended to describe the general nature and levels of work being performed. They are not intended to be construed as an exhaustive list of responsibilities, duties and skills of personnel so classified.This is not an employment agreement or contract. Management has the exclusive right to alter this job description at any time without notice.The Washington Health Benefit Exchange is an Equal Opportunity Employer (use this link:https://www.dol.gov/agencies/ofccp/posters). All qualified applicants will receive consideration for employment without regard to race, color, religion, age, marital status, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.We participate in . You can view the Department of Justice's Right to Work poster .

Keywords: Washington Health Benefit Exchange, Olympia , Senior Sponsorship Specialist, Accounting, Auditing , Olympia, Washington