Director of Partner Relations (Remote)

Health Plans, Inc. (HPI) is a New England-based Third-Party Administrator (TPA) of self-funded health and benefit plans. HPI was founded in 1981 to provide comprehensive health plan administration to employers, municipalities, and Taft-Hartley plans. Health Plans has grown to become an industry-leading TPA by offering customized self-funded benefit plans to employers, combined with superior customer service and investment in the latest administrative and data-mining technology, and reinsurance (stop-loss) security.

Summary:

The Director of Partner Relations is responsible for leading a specialized business area primarily focused on prioritizing the needs of our valued client, broker, provider and network partners. The department not only improves overall responsiveness, but also identifies and tracks trends and opportunities for cross-functional improvement. 

The Director will have subject matter expertise in the customer service/call center industry as well as a strong knowledge of medical claim operations. This role will meet and work regularly with provider organizations of all sizes discussing the impact HPI has on their revenue cycle management and identify strategies to improve timely resolution of claim-related concerns. The Director will make a priority of the timely responses to partner departments on all escalations and inquiries, as well as work to make sure the department employees also respond timely to all inquiries.

As a leader in the Customer Service and Partner Relations team, the Director will also provide support within the team to move forward all customer experience related agendas. This includes, but is not limited to, offering insights and support with telephony systems, customer channel projects and other efforts impacting the experience of our customers. 

Duties and Responsibilities:

• Lead the hiring, training, review, and performance management of the Partner Relations team.  
• Manage overall performance of Member Appeals and Imaging Services.
• Support optimal performance through ongoing training, support, and education.
• Address and resolve escalated member, employer, and provider issues, including for group A25.
• Ensure compliant and timely resolution of all member appeals received by HPI.
• Provide detailed reporting on Member Appeal cases for URAC and other specific requests.
• Represent department on other company project teams as needed to achieve company objectives.
• Lead cross-functional projects that support department and company goals.
• Support Customer Service in pharmacy-related issue resolution.
• Design, develop, and deliver comprehensive and timely in-person and computer-based training programs related to key company projects or programs.
• In partnership with project teams, develop comprehensive testing plans, perform testing, report issues, and collaborate on resolution for key company and department projects

Education Requirements:

• Bachelor’s Degree or equivalent work experience  

Experience Requirements:

• Minimum of 7 years’ management experience within the health insurance industry
• Strong familiarity with industry and related terminology
• Ability to provide leadership in alignment with organizational goals and have the ability to quickly adapt to changing processes with minimal supervision
• Ability to manage in a production/customer service environment within specific timeframes
• Proven leadership and supervisory experience, including performance management skills
• Ability to collaborate with other departments and communicate both verbally and in writing effectively
• Advanced skill level in Microsoft Office, including Word, Excel, and Outlook, as well as other common software used to support the business function of the company

Why choose us?

• Our space is a reflection of who we are—innovative, open and collaborative.
• Love to get creative? We do too. Brainstorm in one of our team break-out rooms.
• We think feeling your best is an important factor in producing great work, so we embrace a “smart casual” dress code and work at ergonomic desks. 
• Need to reenergize? Take a break to chat in the onsite café, go for a walk on one of the beautiful trails in our office park, or get in a quick workout at one of the campus gyms. 
• We offer our employees flexible work arrangements including remote and hybrid options (depending on the position)
• We’re a people-first compan