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Client Services Mgr- TPA

Description

Purpose:
The Client Services Manager will serve as a primary business lead for implementation and ongoing support of Evolent Clients. This role will provide ongoing support throughout the implementation process to the client and clearly communicate plan design and customer specific needs to the assigned staff. Following implementation of a new clients, they will provide leadership, guidance and direction to administer absence management programs for the external clients. The supervisor will manage the workflow of their staff; and ensure compliance through periodic quality review audits.

Responsibilities:

  • Responsible for the preparation of communications, training, and resource materials for staff and clients.
  • Identify areas of potential compliance risk and develop solutions for risk mitigation
  • Provide management oversight for overall program performance and day to day service delivery. Supervisor oversees the resolution of service issues and tracks turnaround time of those issues for reporting to the clients to ensure client expectations and Service Level Agreements are being met or exceeded.
  • Develop and manage compliance and operational reporting matrix that continuously monitors TPA performance. Analyze, evaluate, and present information concerning factors such as business situations, production capabilities, and design and development of system processes to all customer levels within the organization. Assist in the development/refinement of policies and procedures both internally and in partnership with clients
  • Manage multiple accounts and work across multiple department disciplines
  • Analyze and trend data to identify inefficiencies and implement process improvement
  • Monitor appropriate project plans for each client implementation.
  • Facilitate client meetings to ensure all discussions are focused on best practice processes and will lead to development of appropriate business rules.
  • Assist in directing system configuration as needed to prepare for the implementation. Conduct on-site meetings with new clients to complete implementation tasks/checklists and develop business relationships.
  • Communicate business rules to individual(s) assigned to the account to avoid issues upon go-live.
  • Provide leadership and direction through developing and updating procedures, programs, determining appropriate standards, and determining training opportunities
  • Ensures business rules are clear and concise.
  • Develop and maintain written documentation for each client implementation.
  • Ensure that all required steps necessary to meet governmental and internal/external standards and regulations are met
  • Facilitate the development of needed working groups throughout the post go-live support process/period to identify problems and implement solutions.
  • Acts as a point of escalation for all implementation and service issues
  • Secure written confirmation from the client for critical decision points throughout the post go-live process/period.
  • Continuously evaluate and document customer needs and all aspects of business processes
  • Serve as liaison to clients with participation in demonstration of operations activities to prospective clients as well as maintenance of communication with established clients
  • Responsible for managing the implementation of new TPA clients (both Evolent and non-Evolent).

 

Qualifications

Bachelor's degree required. 3 years of supervision/management experience required. Must be self-motivated and have the ability to work independently and handle multiple priorities and deadlines simultaneously with minimal guidance. Excellent written and oral communication skills. Excellent leadership skills. Strong problem solving, analytical and decision-making skills. Customer service oriented with the ability to handle emotionally charged situations. Demonstrated time management skills, ability to prioritize and identify critical tasks that deliver highest impact. Must possess excellent analytical, troubleshooting and problem-solving skills; sense of urgency, responsiveness and judgment to make effective decisions is required. Understanding of TPA line of business is preferred. Knowledge of individual marketplace/on and off exchange plans preferred Ability to work effectively across a large, highly matrixed and dynamic organization. Must possess a strong attention to detail as well as the ability to think and plan strategically. Willing to learn new technical, business and system skills. Computer skills/literacy a must, including proficiency in Microsoft Office products

Licensure, Certifications, and Clearances:

UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Location: Pittsburgh, PA, United States
Job ID: 05516222

UPMC is an equal opportunity employer.
Minority / Females / Veterans / Individuals with Disabilities