The Affinity Program Manager is responsible for developing and maintaining relationships with Affinity Programs, Medical Providers and Cost Containment Partnerships; including the analysis of health care utilization, discounting of medical bills, contracting and streamlining the process. Ultimately, this role is focused on optimizing our client experience with our Affinity partners and facilitating the renewal. Essential Duties & Functions Reasonable accommodations may be made to enable individuals to perform the essential functions. Affinity:
- Serve as key point-of-contact for on-boarding, stewardship and escalation of Affinity Programs, ensuring the quality of services provided by A-G Specialty Insurance
- Manage metrics and analytics associated with Affinity Programs, Medical Providers and Cost Containment Partnerships
- Coordinate Affinity Program Cost Containment Strategies, including Primary Health Insurance utilization, Direct Discounts and Pre-negotiation when appropriate
- Work closely with Clients, Medical Providers and Partners serving as escalation contact and assisting with high profile requests
- Work closely with Claims Management Team, and Affinity Program Claims Team to deliver fundamentally sound claim handling, achieving compliance in the areas of investigation, coverage, and processing of claims
- Assist Claims Management Team with appeals and complex claim scenarios as needed
- Collaborate with all stakeholders and the various A-G Departments to design, implement and maintain systems that enhance the quality of A-G Services
Program Management:
- Serve as key account point-of-contact for reporting and stewardship (facilitate the renewal) including delivering policies and invoices, communicating with key account stakeholders, and managing accounts receivables in coordination with Accounting
- Orchestrate on-boarding of new accounts
- Manage metrics and analytics reporting including reviewing monthly account reconciliation reports & account funding
- Deliver and provide expert analysis of quarterly & annual stewardship reports
- Deliver and provide expert analysis of ad hoc reporting as requested
- Coordinate facilitation of renewals with Underwriting and Sales Team
- Ensure annual documents are fully executed upon program renewal. i.e. TPA Agreements, Contracts, Vendor Information Forms, etc.
Job Skills
- Close attention to detail a must
- Ability to build client relationships with Providers, Schools, Athletic Programs
- Prioritize tasks appropriately and maintain organization
- Self-starter and self-disciplined in accomplishing tasks
- Professional and positive attitude
- Team Player
- Ability to work in a fast paced, changing, and growing environment
- Strong analytical skills.
- High Degree of experience and familiarity with contracting and COB management as it relates specifically to Affinity accounts
- Effectively operate computer and phone systems and applications including Microsoft Office suite of products, call center & support suite software
Job Qualifications To succeed in this role, an individual must be able to perform each essential duty effectively. The requirements listed below 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. Required/Preferred Education and Experience Required Education: Bachelor's Degree Preferred Experience: Master's Degree with 5+ years experience in Athletics, Insurance, or other related fields. 3 - 10 years claims processing experience, 3 years contracting experience, 3 years of Affinity Program claims processing, 3 - 8 years insurance experience, Medical Billing or Coding experience Work Environment This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and scanners. Position Type and Expected Hours of Work This is a full-time position and can be a remote role. Days and hours of work are Monday through Friday, 8:30 a.m. to 5 p.m. The schedule for this role can be contingent upon Supervisor and Human Resources approval. Some evening and weekend work may be required. Travel Some travel may be required for this position.