Student Health Plan Manager

Student Health Plan Manager

About the Opportunity

This job description is intended to describe the general nature and level of work being performed by people assigned to this classification. It is not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.

JOB SUMMARY

The Student Health Insurance Manager reports to the Director of Student Affairs Finance and Administration and works with the Registrar's Office, Student Accounts, Information Technology Services, and other key university personnel and external partners to provide strategic and tactical leadership for the university with respect to the Northeastern University Student Health Plan (NUSHP) student health insurance program and other insurance options and selected health resources. Duties include:

• Develops, implements, monitors, and manages procedures and processes for over 20,000 student health insurance members under the Northeastern University Student Health Plan (NUSHP)
  
  
• Coordinates “One-Stop” and orientation workshops and other events for new and returning students in conjunction with the Orientation Office, Office of Global Students, and College of Professional Studies
  
  
• Develops materials and delivers orientation sessions and one-on-one advisement/consultations daily about the student health insurance program and other insurance options and selected health resources to all active and potential enrollees
  
  
• Serves as liaison to the offices within the Senior Vice Chancellor for Student Affairs as well as other university colleges and regional campuses on student health insurance and student activity issues
  
  
• Represents NUSHP for Student Affairs at Northeastern-wide meetings and fosters communication among Northeastern units
  
  
• Manages and maintains all records, enrollment changes, and dependent information for all of the 20,000+ students enrolled in NUSHP
  
  
• Conducts assessment of program effectiveness through data and statistical summaries, develops strategies for promoting NUSHP
  
  
• Educates students regarding managing health insurance, directs students to claims appeal resources and explanation of benefits
  
  
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• Supervises NUSHP Program Manager and directs programs and projects
  
  MINIMUM QUALIFICATIONS
  
  Knowledge of health insurance and medical terminology procedures and industry standards required. Knowledge of medical and dental insurance plans and ability to interpret insurance language: HMOs, PPOs, benefits and deductibles, co-pays, maximum benefits, coverage limitations and eligibility requirements. Effective skills in communication, both oral and written, required. Ability to clearly communicate complex policies and procedures to students and public through phone and personal conversation, written correspondence, social media, newsletters, and brochures. Proficiency in the use of various computerized databases, student information system (Banner preferred), and medical records management system. Ability to accurately enter and retrieve information from computerized systems. Excellent organizational skills to manage multiple ongoing projects simultaneously and to maintain workflow with numerous interruptions throughout the workday. Ability to initiate project design and direction. Ability to develop positive cooperative working relationships to interact and negotiate effectively using tact and diplomacy. Attention to detail and ability to maintain confidentiality in all aspects of position. Knowledge and skills required for this position are typically obtained through a bachelor's degree - preferably in business, insurance, or related field; and at least 4-6 years of relevant experience with the health insurance industry and medical billing practices. Advanced health insurance training (e.g., CEBS) preferred.
  
  KEY RESPONSIBILITIES & ACCOUNTABILITIES
  
  1) Plan Management; Plans, manages, and coordinates all program functions of the Student Health Plan: *Counsels the Health Center staff, students, parents, university professionals, and outside providers on all provisions of the NUSHP including eligibility requirements and for the use of the Student Health Center. *Advises and instructs the Health Center's Administrative staff and Health Center's Providers regarding billing and documentation policies, procedures, and regulations, if relevant. *Participates in development of annual budget by researching historical data and estimating program expenses. Monitors and with supervision, approves expenditures. Monitors eligibility for enrollment; manages and resolves issues regarding student and dependent eligibility. *Works with members and student account and student services staff to resolve, within TPA (Third Party Administrator) policies and procedures, complex billing and accounts receivable issues. *Ensures claims and payments are processed in a timely manner, including third party payment denials and requests. *Identifies potential plan performance and benefit design enhancements and/or modifications to ensure cost effectiveness of the program. **Resolves problems and handles inquiries related to the NUSHP plan and benefit coverage. *Analyzes and interprets complex claim records to identify and determine amount and nature of billable services in any clinical area.
  
  2) Administration and Supervision; *Manage the NUSHP Program Manager. The Program Manager is responsible to interpret and apply guidelines in order to appropriately answer questions. *Oversee the response to calls from parents, students, staff, and others regarding the NUSHP in a timely, accurate, and professional manner and manages any escalations. Ensures the Program Managers screens, reviews, and prioritizes incoming correspondence and e-mail and handles and/or forwards to appropriate individuals for action. *Manages NUSHP records and correspondence for internal and external use. These include insurance plan benefits changes, coverage eligibility, vendor and insurance agreements, inventory of all referrals, benefits checklists, plan documents, brochures, marketing materials, and other NUSHP files and materials. Serves as point of contact for consultants and outsourced services.
  
  3) Marketing/Communication *With university supervision and in accordance with brand guidelines, coordinates publicity activities including draft brochures, campaigns, social media and newsletters. *Ensures the NUSHP website is accurate and up-to-date *Manages student and parent surveys and other marketing assessment activities. *Provides explanation and information to students regarding insurance coverage, deductibles, co-pays, and authorization requirements. *Provides insurance eligibility and referral information to the third party administrators.
  
  Position Type
  
  Human Resources
  
  Additional Information
  
  Northeastern University is an equal opportunity employer, seeking to recruit and support a broadly diverse community of faculty and staff. Northeastern values and celebrates diversity in all its forms and strives to foster an inclusive culture built on respect that affirms inter-group relations and builds cohesion.
  
  All qualified applicants are encouraged to apply and will receive consideration for employment without regard to race, religion, color, national origin, age, sex, sexual orientation, disability status, or any other characteristic protected by applicable law.
  
  To learn more about Northeastern University's commitment and support of diversity and inclusion, please see www.northeastern.edu/diversity.
  
  
  To apply, visit https://northeastern.wd1.myworkdayjobs.com/en-US/careers/job/Boston-MA-Main-Campus/Student-Health-Plan-Manager_R107689 jeid-79dcaf4ae5b1594cbf3a0a05c55f9a48