What are the responsibilities and job description for the Manager Operations - AICK position at Blue Cross and Blue Shield of Kansas?
The Manager Operations is responsible for the processing of all new enrollment and maintenance of group/individual insurance policies and responsible for the claims processing functions for all products sold by Advance Insurance Company of Kansas (AICK). The position oversees the development of policies and procedures related to administration and claims. The Manager Operations develops and maintains strong partnerships with brokers and Blue Cross and Blue Shield of Kansas (BCBSKS) marketing personnel as well as ensures that subsidiary activities are compatible and in support of the parent company.
Compensation
What you’ll do
Knowledge/Skills/Abilities
Benefits & Perks
Are you ready to make a difference? Choose to work for one of the most trusted companies in Kansas.
Why Join Us?
- Make a Positive Impact: Your work will directly contribute to the health and well-being of Kansans.
- Lead and Inspire: Guide and mentor your team to achieve their full potential and success.
- Dynamic Work Environment: Collaborate with a team of passionate and driven individuals.
- Trust: Work for one of the most trusted companies in Kansas
- Stability: 80 years of commitment, compassion and community
- Balance: paid vacation and sick leave with paid maternity and paternity available immediately upon hire
Compensation
$96,800 - $115,000 annually
Exempt 17
Exempt 17
- Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The compensation range for this role is a good faith estimate, it is estimated based on what a successful candidate might be paid. All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive wages that align with the individual's skills, education, experience, and training. The range may vary above or below the stated amounts.
What you’ll do
- Direct and manage group policyholder division, the preparation of all AICK contract and certificates, including the establishment of all reports, as well as development of major policies and procedures related to all membership and billing processing.
- Direct and manage claims processing, including denial or approval of claims. Coordinate claims issues with internal staff and management as well as external customers and BCBSKS marketing personnel to ensure that claims are paid in an accurate and timely manner. Work with reinsurer if claim issues arise with regards to payments, complaints, investigations and/or litigation. Assure that all claim practices comply with ERISA guidelines and that AICK complies with NAIC unfair claims practices. Also work with BCBSKS legal counsel as needed.
- Participates in the formulation of the corporation’s overall policies and strategic planning regarding the operation of the life insurance subsidiary corporation. Prepare information for timely submission of reports and AICK Board materials.
- Assist with the life subsidiary budget, making sure appropriate allocation of expenses are prepared and monitored.
- Facets Product Owner. Develop, direct and recommend necessary system changes and modifications to insure efficient administration of policies and records. Evaluate and recommend new system software and hardware as needed.
- Examine and evaluate the workflow and administrative processes within the administration and claims areas. Develop procedures that assure efficiency and accurate administration of all group insurance policies.
- Oversee the preparation of commission/compensation procedures. Develop and recommend administrative procedures for reporting of commission/compensation agreements for agents and brokers.
- Must understand the functions of underwriting and communicate with them to ensure internal and state regulations are being followed accurately.
- Responsible for maintaining an awareness and understanding of the business unit recovery plan for the department you work in and the corporation’s business continuity program in general.
- Accountable for performance monitoring, policy enforcement, termination process, disciplinary action, hiring, compliance and team development. Maintaining accurate records of all hiring, firing and disciplinary actions.
What you need
Education and Experience
- A high school degree and proven work experience in insurance administration. Bachelor’s degree in business, marketing or a related field, preferred.
- Minimum of 5 years’ progressive, relevant experience within direct or related field.
- Minimum of 2 years’ leadership or supervisory experience
- Management experience related to claims processing is preferred.
- Demonstrated experience in engaging with customers/vendors and handling long term value contracts.
Knowledge/Skills/Abilities
- Must have interpersonal skills; diplomacy, ethics, integrity and flexibility
- Must have the ability to make independent decisions.
- Must have strong analytical skills and be able to appraise risks and judge the cost/benefits of changes in administrative and claims policies.
- Must have a good understanding of group insurance laws and regulations.
- Must be persuasive and able to identify and resolve brokers/BCBSKS Sales objectives to individual items found in insurance policies.
- Must be able to work and negotiate with reinsurers regarding new and existing business and claim processes.
- Must be able to assist underwriting in maintaining a balance of new sales and underwriting profits. Has considerable responsibility for the retention of group/individual insurance policies.
- Must be able to demonstrate project management and leadership skills
- Negotiate with reinsurers and legal counsel on claim settlements when necessary.
Benefits & Perks
- Base pay is only one component of your competitive Total Rewards package
- Incentive pay program (EPIP)
- Health/Vision/Dental insurance
- 6 weeks paid parental leave for new mothers and fathers
- Fertility/Adoption assistance
- 2 weeks paid caregiver leave
- 5% 401(k) plan matching
- Tuition reimbursement
- Health & fitness benefits, discounts and resources
Our Commitment to Diversity, Equity, Inclusion, and Belonging
At Blue Cross and Blue Shield of Kansas, we are committed to fostering a culture of diversity, equity, inclusion, and belonging (DEIB), where mutual respect is at the foundation of our workplace. We provide equal employment opportunities to all individuals, regardless of race, color, religion, belief, sex, pregnancy (including childbirth, lactation, and related medical conditions), national origin, age, physical or mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military or veteran status, family or parental status, or any other characteristic protected by applicable law.
We believe that embracing diversity and authentically promoting inclusion, equity, and belonging among our team members is crucial to our collective success. By intentionally recruiting, developing, and retaining a diverse pool of talent, we cultivate an environment where everyone feels valued, heard, and empowered to contribute. Accommodations are available for applicants with disabilities upon request, ensuring an inclusive and accessible hiring process for all.
Salary : $96,800 - $115,000
