Overview In this role you will support health care program administration and sales enablement. You will analyze program specifications, draft contract language and benefit comparisons, and coordinate implementation of changes across groups. You will lead cross-functional workgroups, test systems, and provide technical expertise for proposals and presentations. Your work helps ensure accurate benefits, efficient processing, and strong customer outcomes. This is a process-driven, cross-team role centered on improving quality and delivery for major accounts.
Responsibilities- Analyze and develop contract language, proposal summaries, and benefit comparisons for major accounts
- Coordinate implementation of group-wide changes with relevant programs
- Identify and initiate system changes to improve quality, processing time, and benefit accuracy
- Coordinate customized and standard proposal components
- Handle account maintenance requests and maintain tracking logs
- Provide technical expertise for proposal development and sales presentations
- Lead workgroup meetings with claims systems, operations, and other teams
- Perform feasibility surveys on program delivery capability
- Interact with business consultants and account management (primarily Michigan)
- Resolve account administration issues for health care programs
- Participate in system testing, develop procedures, and suggest process improvements
- Maintain effective relationships with accounts, service management, customers, and programs
Key requirements- Bachelor's Degree in Business Administration, Computer Science, Health Care Administration, Marketing or related field (preferred)
- Three to five years of experience in Customer Relations, Operations and/or Product Development
- In-depth technical knowledge of benefits, rating, underwriting, enrollment, administration, and policies for sales and marketing programs
- Strong knowledge of quality control mechanisms and systems
- Extensive knowledge of BCBSM and/or BCN operations
- Excellent analytical, decision-making, organizational, planning, and communication skills
- Ability to establish and maintain internal and external relationships
- Knowledge of claims processing techniques and system analysis and design
- Proficiency in PC applications and systems
- Experience in benefits, claims processing/inquiry training, cost containment, marketing and systems
- Valid Michigan driver's license; travel as required
- analytical thinking
- strong communication skills
- relationship-building
- expert level Excel (dashboards, pivot tables)
- Salesforce
- program specifications analysis
