Product Administrator

Avera Health Plans

Worker Type:

Regular

Work Shift:

Day Shift (United States of America)

Pay Range:

The pay range for this position is listed below. Actual pay rate dependent upon experience.

$53,040.00 - $79,560.00

Position Highlights

You Belong at Avera

Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter.

A Brief Overview

Responsible for coordinating and administering specialized product development, compliance, and ongoing maintenance activities.

What you will do

• Coordinate and administer the annual review of existing products and performance in collaboration with the sales and underwriting departments under the direction of leadership.
• Coordinates the implementation of ACA and Medicare program requirements and works with the necessary operational teams within Avera Health Plans on execution of the requirements.
• Administers all facets of Avera Health Plans products on the Marketplace including User Acceptance Testing (UAT) and SEED as examples.
• Manages and files documents and templates related to Medicare and ACA products, including Federal (QHP) filings and Division of Insurance filings in coordination with Compliance and appropriate departments.
• Creates and updates summary of benefits and coverage documents, summary plan descriptions, certificates of coverage and required member communications in collaboration with an internal workgroup always seeking ways to automate the process.
• Attends and communicates internal follow up from REGTAO, AHP, and other regulatory calls regarding the marketplace.
• Creates and maintains databases that address product requirements such as communication databases, HICS databases, commission databases, etc.
• Coordinates with internal team on the HICS process and audit for individual marketplace enrollees and works with CMS to resolve.
• Key resource for information regarding product design and implementation of the Affordable Care Act and its impact to internal and external clients.
• Be the liaison in coordination with external vendors to ensure functionality and accurate representation of ACA products.
• Responsibilities include interviewing, hiring, developing, training, and retaining employees; planning, assigning, and leading work; appraising performance; rewarding and coaching employees; addressing complaints and resolving problems.

Essential Qualifications

The individual must be able to work the hours specified. To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer.

Preferred Education, License/Certification, or Work Experience:

• Bachelor's
• 1-3 years of related experience and/or training

Expectations and Standards

• Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community.
• Promote Avera’s values of compassion, hospitality, and stewardship.
• Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity.
• Maintain confidentiality.
• Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment.
Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable.

Benefits You Need & Then Some

Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future.

• PTO front-loaded for eligible hires

• Free health insurance options, for full-time single coverage on Avera High Deductible Health Plan

• Up to 5% employer matching contribution for retirement

• Career development guided by hands-on training and mentorship

Avera is an Equal Opportunity/Affirmative Action Employer Minority/Female/Disabled/Veteran/Sexual Orientation/Gender Identity. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@avera.org .