What are important things that YOU need to know about this role?
Remote Opportunity with Travel Requirements: Enjoy the flexibility of working fully remotely while accommodating occasional travel needs to support meetings and client engagements approximately 25%-30% of the time
Vision Industry Knowledge: Extensive experience in the vision benefits or third-party administration (TPA) space is required, with a strong understanding of managed vision care, provider networks, and claims administration processes.
SaaS Expertise: Proven experience working with Software-as-a-Service (SaaS) platforms is essential, with a strong understanding of subscription-based business models and cloud solutions.
What will YOU be doing for us? Responsible for ensuring client satisfaction and account performance through monitoring and overseeing all aspects of contract performance, and service requests, including resolving customer concerns. Responsible to ensure effective implementation of new markets and products/services. Maintain effective relationships with client operational leaders to ensure positive client references and client renewals, facilitate effective resolutions to issues, and identify potential opportunities for additional business. Coordinate messaging to the client as it relates to service requests, service issues, and CAPS. Expected to be an expert in client contracts and responsible for adherence to the client request process. (The term ‘clients’ referenced throughout this job description refers to the clients specifically assigned to the Service Manager.)
What will YOU be working on every day?
Successful Client Relationships
Responsible for overall client satisfaction by coordinating, preparing and delivering internal client updates, monitoring deliverables and SLAs to be sure commitments are met via tracking mechanisms.
Has responsibility for overall client service delivery by assigning and directing Account Managers.
Responsible for messaging to client related to escalated, high profile, or sensitive issues with little input from the Client Experience Executive; provides guidance to Account Managers as needed.
Primary Liaison to client on service levels, issues, and other detailed information to support delegated work. Coordinate high-level meetings (onsite client visits), ensuring established and published agenda prior to the meeting as well as published, formal meeting notes
Ensure client requests/deliverables are within contract scope and work with the Client Experience Executive on out of scope items.
Ensures the client as well as the Account Managers follow the Client Request Process
Determines any additional workflows and processes needed to supplement the Client Request Process to best service assigned clients and directs Account Managers to carry out these workflows and processes
Collaborate with other SKYGEN USA teams on the successful development, production and delivery of client deliverables as well as the establishment of process efficiencies to ensure success and low-cost/resources.
In collaboration with project management, plan and execute the startup of new products and services for the assigned clients; confirm the documentation of client decisions. Responsible to ensure configurations conform with client requirements.
Develop client relationships through visits and phone calls to resolve and avoid problems. Work closely with internal teams assigned to clients to ensure requests are resolved within appropriate timeframes.
Work closely with the Client Experience Executive in ongoing account planning as well as to monitor service delivery and client satisfaction with products and services.
Quantify client activity and outcomes for internal monitoring and reporting.
Responsible for management of any Account Managers or Senior Account Managers assigned to the Service Manager, e.g., internal and external messaging, navigating internally toward solutions.
Determines assignments to Account Managers or Senior Account Managers and even distribution of work based on experience and skills (e.g. market assignments, special projects, etc.).
Ensures work assigned to Account Managers and Senior Account Managers will help develop their skills.
Identify and evaluate trends in client concerns for suggestions to improve organizational processes.
Analyze client surveys with the Client-specific experience team to identify areas for improvement and development of action plans.
Escalated Issues
Escalation point for Account Manager and Senior Account Manager on high priority issues such as penalties, corrective action plans (CAPs), critical requests, and compliance issues. Provide advice and direction as needed.
Works with other SKYGEN managers and directors to resolve escalated issues.
Participates in and/or direct activities related to responding to CAPs. Proactively escalates issues related to CAPS, penalty risk, compliance issues, problems, issues and status updates to appropriate parties such as Client Experience Executive, compliance, CFO, and internal department heads.
Tactfully respond to escalated requests including when there is delay(s) in response, response was not considered satisfactory, or request cannot be met.
Audits
Oversees Account Managers to ensure a smooth client onsite audit; delegates
Participate in the determination and implementation of corrective action plans surrounding contractual requirements and perhaps identified in audits.
In collaboration with the QA staff, document and monitor internal progress on corrective action plans.
Process Improvement
Maintain knowledge of industry trends to effectively address client concerns.
Develops expertise in SKYGEN processes, Enterprise system and other systems to identify areas for continuous improvement goals.
Identifies prospective client opportunities and share client leads with Client Experience Executive for appropriate follow up.
Identify potential efficiencies and workflow improvements based on knowledge of industry and internal business practices.
What qualifications do YOU need to have to be GOOD candidate?
Require Level of Education
Bachelor’s degree in Business or other related field or equivalent years of related experience
Required Level of Experience
5+ years previous experience acting as primary contact for service concerns for large health insurance clients.
1-3 years of training peers, or mentoring
Experience in complex project management in regulatory environments.
Required Knowledge, Skills and Abilities
Demonstrated conflict management skills; well-honed communication skills and ability to hold others accountable.
Demonstrated ability to learn and work in complex environments with a continual learning approach.
Ability to navigate potential internal and/or external roadblocks and negotiates obstacles; influence stakeholders as appropriate; seeks compromise when necessary
Solid administrative skills in the areas of project planning, organizing and time management
Ability to travel quarterly.
Strong knowledge of Microsoft office products (Excel, Word, and email) at an intermediate level.
Ability to manage multiple priorities and ensure timelines and deadlines are met. Visio preferred.
Ability to communicate and work with a diverse group of internal and external individuals from administrative to c-suite.
Ability to effectively understand the industry and organization’s products/services and apply appropriately.
Effective communication skills both in person and in written documents.
Ability to effectively present thoughts and respond to questions in a public speaking opportunity.
What qualifications do YOU need to have to be a GREAT candidate?
Preferred Level of Education, License, and/or Certificates
Bachelor’s degree in Business, Marketing, or other related field of study
Project Management Experience
Preferred Knowledge, Skills, and Abilities
Preferred experience in health care insurance operations and/or servicing large health insurers
Knowledgeable of various dental and health care products.
Expertise in various areas of the Enterprise system
Workflow optimization for efficiency and potential cost savings
Knowledgeable of medical terminology, procedures, and CDT procedure coding.
Basic SQL and relational database knowledge
Compensation Range:
$88,164.00 - $132,246.00Compensation Midpoint:
$110,205.00Loading similar jobs...
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