MA Group Consultant

<strong>At Emergent Holdings, we&rsquo;re creating an innovative environment where our employees belong authentically, contribute meaningfully, and thrive intentionally &mdash; both personally and professionally.</strong>

New York, USA

Emergent Holdings

<p class="p1"><strong>Emergent Holdings is driven by a singular goal &mdash; improving the health and safety of our customers and our communities. How do we do that? We create innovative insurance products, technology solutions, and services to support our key stakeholders &mdash; individuals, employers, providers, and strategic partners &mdash; improving the health and safety of the people and places we serve.</strong></p>

keywords: summary,job description,work environment,reporting,strategy,goals,other duties,experience,education,skills


Competitive Compensation and Benefits Package

Overview: <br />The Medicare Advantage Group Consultant&nbsp;is responsible for leading and facilitating all aspects of Medicare Advantage group operations for all Covantage Joint Venture health insurance plans. Responsibilities for this role include oversight and management of the group RFP/proposal process, new group implementations, group operations, and the renewal process. Additionally, this role will be responsible for supporting group strategy development and will also have vendor oversight responsibilities. The MA Group Consultant will coordinate activities across a highly matrixed team including Sales, Marketing, Actuarial, Clinical, Operations, Compliance, and Project Management Office.<br /><br /> <p><strong>WORKING CONDITIONS:</strong></p> <p>Work is typically performed in a home office setting with no unusual hazards. Infrequent travel is required (max 1-2 trips per quarter). Virtual candidates will be considered.</p>
Responsibilities: <br /> <ul> <li>Provides day-to-day expertise and strategic direction to employer group customers and group account managers on Medicare Advantage (MA) product, benefits, and services</li> <li>Works in tandem with account manager to ensure support from all angles &ndash; supports triage to MA functional experts</li> <li>Oversees all four phases of group operations and is accountable for planning and ensuring milestones are achieved: <ul> <li>Proposal/RFP development</li> <li>New group implementation</li> <li>Operations</li> <li>Renewals</li> </ul> </li> <li>Responsible for supporting group strategy development and group-specific vendor oversight, i.e. group enrollment platform vendor.</li> <li>Works with reporting teams to ensure timely and accurate reporting on performance and performance guarantees</li> <li>Responsible for managing and balancing competing priorities across multiple Joint Venture (JV) health plans</li> <li>Build and maintain group operations readiness checklists</li> <li>Own and update key group deliverables and artifacts such as group playbook, customer manual, and standard reports</li> <li>Participate in development of budgets, monitor budget, and identify budget discrepancies.</li> <li>Responsible for reporting group performance internally to Plan Presidents and internal executive leadership</li> <li>Create meeting agenda(s) at least 24 hours in advance of meetings and distribute meeting minutes; Document and track follow-up items from meetings</li> <li>Lead all aspects of work track project management and ensure compliance to all processes including accuracy, consistency, and timelines</li> <li>Build and maintain working relationships with team members, vendors, and other departments.</li> <li>Implement process improvement initiatives that help standardize ongoing tracking and improve overall efficiency</li> </ul>
Requirements: <br /> <p><strong>EDUCATION OR EQUIVALENT EXPERIENCE:</strong></p> <ul> <li>Bachelor&rsquo;s degree required; Master&rsquo;s preferred.</li> <li>Combinations of relevant education, certifications, and experience may be considered in lieu of a degree.&nbsp;</li> <li>Continuous learning, as defined by the company&rsquo;s learning philosophy, is required.</li> </ul> <p>&nbsp;</p> <p><strong>EXPERIENCE:</strong></p> <ul> <li>Five&nbsp;or more&nbsp;years of experience required with demonstrated technical experience that provides the necessary knowledge, skills, and abilities.&nbsp;&nbsp;</li> <li>Previous experience in the insurance industry and with employer business, commercial or retiree, is required.</li> <li>Experience with Medicare Advantage groups is strongly preferred.</li> </ul> <p>&nbsp;</p> <p><strong>SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:</strong></p> <ul> <li>Strong understanding of insurance markets, including Medicare.</li> <li>Advanced proficiency with standard tools, including Microsoft Excel, Microsoft PowerPoint, and Microsoft Project.&nbsp;</li> <li></li> <li>This position requires strong&nbsp;strategic and tactical planning and organizing skills.</li> <li>Strong understanding of end-to-end health plan operations</li> <li>Advanced oral, written, and presentation skills, as necessary to effectively and concisely present externally to customers and internally to executive leadership.</li> <li>Ability to establish workflows, manage multiple projects, and meet necessary deadlines.</li> <li>Ability to use independent judgment and initiative to anticipate leadership needs and accomplish tasks with minimal direction.</li> <li>Ability to perform assignments at locations outside the office if required</li> <li>Ability to work with and empower others on a collaborative basis to ensure success of teams.</li> </ul>