Manager, Contracts and Benefits

HealthPartners is hiring a Self-Funded Manager of in our Contracts and Benefits department. This role provides HealthPartners and related organizations with:

Direction for the Contracts & Benefits department staff, production, and operation, in providing contracts and associated services required by the corporation to satisfy corporate contract obligations to external and internal customers, through the timely, effective and legal delivery of contracts for new, or changes to current, products in the marketplace, which is integral to attracting new business and sustaining a satisfied current customer base.

Assurance that corporate contract obligations are met through the delivery of contracts and services for its product-portfolio of group and individual, fully-insured and self-funded, medical and dental products; CDHP products; Medicare and Medicaid products; or reinsurance and other risk products, including administration only products.

Assurance that contracts are in line with relevant state and federal regulations and product specific mandates for group and individual coverage. Assurance that the benefits, risk, networks, costs and terms agreed to by our organizations, or as mandated, are reflected as appropriate, to ensure related enforcement, prevent exposure to fines or litigation, to protect our interests and assure our financial success.

Management of regulatory compliance services and the securing of regulators' approvals for contracts, as pre-requisite in corporate pre-sale marketing or use in implementation and required as post-sale evidence; assuring appropriate enforcement through contracts and preventing potential revenue loss by exposure to regulatory fines for non-compliance or litigation.

Direction for related contracts development, implementation, and employer account services, which are responsive to diverse corporate strategic objectives and constituents, as well as regulators, meeting multiple goals and purposes, through appropriate contracts approved by the corporation and as pre-requisite to regulatory-approvals and broad customer implementation.

Direction for related contracts production services, pre-requisite in the shelf and custom product creation of relevant contracts to be furnished as post-sale evidence for customer account installation and mass-print production for membership-delivery; reporting and other key administrative services, essential in uniform or targeted application and enforcement, protecting corporate interests, collecting revenue due and preventing exposure to fines and litigation.

ACCOUNTABILITIES:

Responsible for the supervision of staff, including having the authority to hire, transfer, lay off, promote, discipline and discharge, train, reward and review performance of employees. Ensures compliance to organizational and departmental policies and procedures.

Administration:

Direct department services, production and operations, as necessary to satisfy required corporate and regulatory contracts obligations to our external and internal customers and authorize relevant provision of department functions, deliverables and services.

Provide administration for the department's related services, functions, customized and generic production, platforms and systems, operations, staff and budget, essential to provide contracts and services effectively and consistently.

Represent the department and functions in corporate teams, relevant to forming policies and in support of policy-initiatives in contracts, to advance contracts interests, requirements etc. for department deliverables.

Determine department deliverables, depending on the initiative, product-type and stage in which a contract is deployed, e.g., in development, regulatory environment and filing, solicitation, sale and administration, to assure effective service in support of a diverse product portfolio in their administration.

Collaborate with multiple external and internal stakeholders or customers in efforts to produce mutually agreed on contracts-deliverables.

Negotiate conflicts or align diverse interests and agendas of relevant stakeholders inherent to Contracts, to provide coherent contracts, content and administration.

Coordinate department's services, with multiple interdependent and/or interdepartmental services, initiatives, requests, communications, administration processes, to culminate in the efficient, compliant and timely production of contracts; essential in the effective provision of all the departments' services and contracts.

Budget and manage department operations and their costs to ensure resources, cost efficiency and maximize financial results.

Devise and establish, revise and implement, all relevant department strategies, policies, functions, procedures and objectives, essential in providing these services.

Oversee the department's various records and record keeping to assure that the corporation, department and auditors have available all original regulatory-filings of contracts; all employer account contracts and sale records, data and reports and other pertinent information; in active file-systems and archival-systems, necessary for inspections or audits by regulators, or for corporate use in contract administration, conflicts, appeals, denials, litigation etc.

Devise and direct implementation of department's annual objectives and long-term goals, to assure meeting relevant objectives and goals to sustain and enhance productivity, improve quality of deliverables or services, functions, processes and systems, in support of corporate initiatives and objectives.

Quarterly and periodically, report to senior management on department's productivity, attainment of production and operations objectives etc., to ensure linkage to and synchronization with HP corporate and other relevant division objectives, including administration division objectives.

Regulatory Compliance, Filing and Approvals:

Manage the department's securing of regulatory approvals for contracts from state and national regulatory agencies.

Negotiate non-standard filing, objections and approval resolutions and participate in regulator's hearings to resolve filing objectives and obtain approvals. Regulatory approval is essential, as evidence of legal contracts, which permit the corporation to market and sell our products in the marketplace and post-sale delivery to purchasers.

Direct the provision of regulatory-compliant contracts, their installation and related services. Compliance is essential to: obtain and maintain regulator's approvals for contracts filings; effective, uniform or targeted application and enforcement of regulatory and corporate policies in a diverse product portfolio; protect corporate interest in development or administration of benefits; and prevent potential revenue loss by exposure to regulatory fines for non-compliance or customer litigation's.

Contracts Development and Implementation:

Direct the department provision of contracts development and implementation services, relative to prototype-contracts, for filings and corporate implementation, essential to obtain and maintain regulators' approvals, implement uniform or targeted application and enforcement of regulatory and corporate policies in corporate and customized contracts.

Assure the availability of optimal flexibility in contract-design permitted within regulatory mandated constraints, to obtain the variability necessary, to allow broad product implementation and selection in underlying plan options, for competitive solicitation in the marketplace, to meet customer specifications in the sale, as well as post-sale delivery to purchasers, with minimal regulatory or production constraints.

Determine how to address uniformly, or in targeted areas, the appropriate regulatory and business policies or practices, network and medical management configurations, product and revenue objectives, and customer specifications, disclosed in contracts.

Participate and coordinate development of coded templates and department database utilization to address needs for production and accuracy of contracts.

Human Resources:

Manage multiple direct-reports accountable for key services and functions; budget earning and benefits; determine staff development; as required to assure optimal productivity in the provision of all department services and production, focused on excellent customer service.

Assure that the department's mission is met; plan and direct diversity awareness activities to meet objectives, to ensure effective, aware, professional and productive staff, meeting corporate and departmental mission and goals.

Other Duties:

Create, update and participate in business continuity and IS&T disaster recovery planning and testing.

Other duties as assigned.

REQUIRED QUALIFICATIONS:

10 years senior contracts and benefits experience in the health insurance industry, which included the following responsibilities.

2 years contracts manager or administrator experience in HMO and/or PPO industry, state and federal regulatory environment, including regulatory compliance and negotiations management. Experience included operations and service management in administration; planning; development; analysis; regulator and customer negotiation for corporate or client-based HMO and/or PPO products of all lines of business; and staff development and training in contracts and benefits administration, product design, regulatory compliance, analysis, and writing.

8 years senior analyst and/or consultant experience with all types of contractual documents including HMO and/or PPO medical/dental contracts, network-access and administrative service agreements, reinsurance agreements and their administration, for fully or partially insured or self-insured products.

Bachelor's Degree in English or other Liberal Arts discipline with documented excellence in research, analysis, and written communication. Liberal Arts degree may be substituted with 4-year degree in Business Administration with same emphasis on research, analysis, and written communication.

PREFERRED QUALIFICATIONS:

Master's Degree in related field; or

5+ years of Contracts & Benefits management experience

DECISION-MAKING:

Direct Contracts & Benefits department operation and staff in all phases of strategic planning, development, implementation, production, and administration.

Authorize all related primary business functions, actions, and transactions necessary to assure efficient production and operations.

Direct and authorize utilization of budget accounts; request approval for budget exceptions from senior director or VP, as appropriate.

Decide department's deliverables and service issues to ensure appropriate services and outcomes, which meet business objectives.

Recommend solutions, advise, or request authorization for resolution of contract issues requiring such interaction or approval to director, senior director, senior management, vice-presidents and/or legal counsel, as appropriate.