Supervisor, Retiree Health Benefits

Responsibilities

• Oversee the Retiree Health Benefits Unit to ensure all Retiree Health Benefits( RHB) for Medicare and Non-Medicare eligible retirees and their spouses via updates to V3 system, Aetna MAPD Optional enrollment files and change files, Express Scripts, RDS, EGWP and Healthfirst and other Third-Party Administrators (TPAs) are processed timely.
• Oversee quality assurance review of bi-weekly Pension Medical Workflow reports to ensure timely enrollment into Aetna MAPD and Surviving Spouse updates and mailings
• Oversee the review and validation of retiree enrollment information received on the Aetna MAPD exception reports, Retiree Drug Subsidy Covered Lives reports via CMS website to ensure alignment with the V3 system and perform required updates accordingly.
• Oversee the processing of ADP timesheets for RHB staff and appropriate review of time and attendance to ensure adherence to Fund policy.
• Oversee the maintenance and creation of Standard Operating Procedures for daily processing of retirees and reporting.
• Training and Development of RHB Coordinators and other eligibility staff to ensure appropriate cross training in retiree health benefits and enrollment updates and changes to the Funds 1199SEIU Medicare Advantage Plan and Healthfirst Medicare Plan
• Processing of ADP e-time and appropriate disciplinary action for time and attendance in accordance with the Funds policy
• Provide support for CMS Subrogation inquiries and research claims and V3 eligibility for appropriate resolution.
• Provide support 1st level and 2nd Level Retiree Appeals
• Understand and resolve complex Medicare Advantage Prescription Drug (MAPD) member inquiries while handling daily workflow processing.
• Support V3 business test cases and UAT to validate system logic changes and program modifications to ensure logic is operating according to business requirements and design specifications for the V3locity migration.
• Review, monitor, and analyze eligibility systemic data quality control reports, vendor export files, and third-party vendor pre-edit reports for active working members, dependents, and retirees/spouses to ensure data integrity.
• Perform additional duties and projects as assigned by management.

Qualifications

• Bachelor's Degree or equivalent years of work experience required.
• Minimum of three (3) years of eligibility experience, including resolving eligibility matters and updating eligibility systems (Vitech, Medco), and (1) one year of experience in a leadership role is required.
• Intermediate skill level in Microsoft Excel, Outlook and Word required.
• Good knowledge of 1199SEIU eligibility benefits for all Funds (i.e., National Benefit Fund, Greater New York and Homecare)
• Excellent customer service skills a must; able to maintain a pleasant and helpful demeanor.
• Excellent oral and written communication skills and ability to speak in a clear and concise manner.
• Ability to prioritize work with tight schedules and target dates.
• Demonstrated organizational skills with ability to multitask and follow up.
• Good problem solver with ability to work independently and as a team player.