PacificSource Health Plans

  • Business Analyst II

    Job Location US-OR-Springfield
    Job ID
    2018-197
    Type
    Regular Full-Time
    Hiring Pay Range
    $20.00-$23.00
    # of Openings
    1
    Status
    Non-Exempt
  • Overview

    Support the development, research, implementation, and maintenance of custom benefits, language and materials, Caremark set-up, of benefits and custom language. Responsible for reviewing, compiling, coordinating, and communicating custom benefits and eligibility for potential, new, and renewing large commercial groups. Ensure accuracy and legal deadlines to ensure compliance and to support other departments in providing customer service.

    Responsibilities

    1. Act as large group custom specialist. Review prior carrier materials for matched variations. Coordinate variations and exceptions. Work directly with Facets Business Support and Compliance to confirm administrative ability and legal compliance.
    2. Develop and maintain language for custom handbooks, summaries, contracts, Distribute for posting on website, InTouch, or RFPs and for filing. Coordinate with Communications legal and compliance on collateral pieces for books and contracts when required.
    3. Set-up and update plan profiles, and with Caremark for pharmacy plan set-up and transitions.
    4. Develop and maintain custom group materials from pre-filing through post-implementation for all commercial custom products, ensuring consistency in language and compliance with state and federal regulations, and PacificSource policies.
    5. Submit custom Facets product set-up requests to Facets Business Support, and research when required.
    6. Maintain job aids and train staff throughout the company on custom benefits. Prepare and conduct educational meetings for specific departments or for all employee meetings.
    7. Collaborate with RFP team for the preparation of custom benefit summaries or other documents for internal and external use.
    8. Work with the sales and service staff to determine large group customizations and renewal changes.
    9. Research set-up issues in Facets or PSEx for various departments, communicates system problems and possible solutions to legal and compliance.
    10. Support the product filing process by reviewing and collaborating with legal and compliance on custom plan requirements.
    11. Document and track custom information related to products, plans, and benefit changes to PacificSource products. Prepare related spreadsheets to assist the Group Account in processing groups.
    12. Coordinate with Legal and Compliance, Facets Business Support, and Product Development to ensure new custom products and eligibility meet regulatory requirements, PacificSource policies, and ability to administer in the Facets claims and eligibility system.

    Supporting Responsibilities:

    1. Meet department and company performance and attendance expectations.
    2. Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
    3. Perform other duties as assigned.

    Qualifications

    Work Experience: Minimum of two years insurance industry experience, and in a position that required research, presentations, and effectively managing multiple projects and deadlines.

     

    Education, Certificates, Licenses: Requires a high school diploma or equivalent. BA/BS preferred.

     

    Knowledge: Strong working knowledge of state and federal laws affecting group health insurance. Thorough knowledge of PacificSource products, contracts, and work flow. Understanding of general underwriting risk concepts. Strong skills in Microsoft Word, Excel, and PowerPoint. Consistently helpful, confident, and pleasant with internal and external customers. Consistently and effectively pays attention to detail, produces high quality work in a timely manner, and strives to increase production without sacrificing quality. Handle sensitive issues with diplomacy and persuasiveness.

     

    Competencies

    Our Values

    • Adaptability
    • Building Customer Loyalty
    • Building Strategic Work Relationships
    • Building Trust
    • Continuous Improvement
    • Contributing to Team Success
    • Planning and Organizing
    • Work Standards
    • We are committed to doing the right thing.
    • We are one team working toward a common goal.
    • We are each responsible for our customers’ experience.
    • We practice open communication at all levels of the company to foster individual, team and company growth.
    • We actively participate in efforts to improve our communities-internal and external.
    • We encourage creativity, innovation, continuous improvement, and the pursuit of excellence.

     

    Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.

     

    Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions.  Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.

     

    Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.

     

    PacificSource is an equal opportunity employer.  All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.

    Apply

    Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
    Share on your newsfeed