Implementation Specialist

 Posted 11 hours ago
     
5-10 years experience
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AI Summary

Lead the implementation process for new TPA groups by coordinating between clients, brokers, and internal departments. Manage documentation, eligibility verification, and the setup of plan administration and external vendors.

Imagine360 is seeking a Implementation Specialist to join the team! Complete and provide TPA implementation services for all new groups following conclusion of the initial sale. This includes the completion of all internal documentation with applicable required data gathered from the Implementation meeting, determining how enrollment and eligibility information will be provided for new clients, and verifying and clarifying all information leading to preparation of new plan administration and benefits design.

Position Location: 100% remote

Responsibilities include but are not limited to:

  • Schedule and lead Implementation meetings with new clients.
  • Coordinate with internal departments to verify products/vendors sold.
  • Coordinate with Administration Department and Pharmacy vendors for eligibility and ID cards.
  • Provide internal documentation of client's plan design/administrative plan to all internal parties.
  • Coordinate client funding/billing with Accounting Department by obtaining bank worksheet, ACH Agreements from Client or banking representative for new clients.
  • Schedule and chair internal departmental meetings to review new client plan design.
  • Coordinate with internal parties to confirm correct loading of client benefits.
  • Coordinate with Plan Document Analyst for completion of Plan Document for new clients.
  • Coordinate with outside enrollment vendors and IT Department to communicate the information required to get enrollment transmitted to Imagine360 electronically for new clients.
  • Coordinate the setup of any external vendors that are being implemented by the client.
  • Periodic travel for internal team meetings as well as implementation meetings with brokers and clients.
  • Perform other duties as assigned.
  • Perform all tasks in accordance with HIPAA/PHI guidelines.

Required Experience/Education:

  • High School Diploma or GED
  • 5 or more years of healthcare insurance related experience

Skills and Abilities:

  • To perform this job successfully, an individual must be able to maintain a high level of accuracy and attention to detail. It is important that an individual be able to speak effectively with other employees of Imagine360, brokers, clients, and vendors. Finally, an individual must be able to deal with problems and exercise sound judgment involving several competing priorities and variables within the parameters of department policy and guidelines.

What can Imagine360 offer you?

  • Multiple Health plan options
  • Company paid employee premiums for disability and life insurance
  • Parental Leave Policy
  • 20 days PTO to start / 10 Paid Holidays
  • Tuition reimbursement
  • 401k Company contribution
  • Company paid Short & Long term Disability plus Life Insurance
  • Professional development initiatives / continuous learning opportunities
  • Opportunities to participate in and support the company's diversity and inclusion initiatives

 

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Imagine360 is a health plan solution company that combines 50+ years of self-funding healthcare expertise. Over the years, we've helped thousands of employers save billions on healthcare. Our breakthrough total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-focused solutions.

Imagine360 is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

 

**RECRUITMENT AGENCIES PLEASE NOTE: Imagine360 will only accept applications from agencies/business partners that have been invited to work on a specific role. Candidate Resumes/CV's submitted without permission or directly to Hiring Managers will be considered unsolicited and no fee will be payable. Thank you for your cooperation**

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