Kaiser Permanente Contract Coordinator II in Portland, Oregon
The Contract Coordinator II is responsible for accurate and timely filing of all contractual insurance documents with state regulatory agencies to enable market and sale of insurance products. This includes complex national accounts, regional strategic accounts, Federal Employees Health Benefits Plan (FEHBP) and Senior Advantage (Medicare) plans. Documents refer to various product-specific iterations of Group Agreements, Evidence of Coverage, Benefit Summaries, riders, applications, and other supporting documents. This position involves business practice research, legal and regulatory reviews, summarizing recommendations for technical writers and executive approvals. It requires exceptional attention to detail, flexibility and high degree of collaboration with multiple cross-functional teams.
Essential Responsibilities: - Custom negotiated group analysis: Provide subject matter expertise for local and national custom accounts. Represent region on national work groups. Analyze changes and summarize for compliance and handoff to partner teams. Contractual document analysis and filing coordination: Populate templates with product-specific benefit data variables to reflect each combination of benefit plans to be filed. Assign and track appropriate form numbers. Conduct peer review / quality assurance for other team members. Reconcile filed content to product standards and ensure that benefits are accurately reflected and comply with state and federal regulatory requirements. Create and monitor compliant SERFF filings to state regulators; communicate and escalate any status changes throughout approval process. Write filing description cover letters that include summary list of contract changes to accompany SERFF filings, in order to anticipate issues and positively influence state regulator review. Serve as point of contact for nonstandard filings. Coordinate and submit responses to regulator comments to ensure timely and strategically appropriate positioning. - Project management: Develop project plans for filing contractual documents to meet mandatory deadlines, engage appropriate work group members, document and communicate status to meet deliverables. Organize all draft and filing documentation, decisions, resource materials for easy retrieval, review and reference. Engage customers and SMEs in negotiation. Compile stakeholder comments, final approvals and documentation. - Content expertise: Respond to information requests and represent team to address document issues in assigned benefits and product lines. Research changes to understand current and proposed business practices, engage Regulatory and Legal to develop recommendations or write provisions as needed. - Collateral review: Review and edit marketing collateral and enrollment forms to ensure alignment with appropriate contractual documents. - Other duties as assigned: Participate on process improvement work groups. Maintain procedures and documentation for all functions performed within this position.
Qualifications: Basic Qualifications: Experience - Minimum four (4) years of project coordination and/or program management, preferably in an area related to health care, contract administration or product management. - Minimum three (3) years experience in an area related to insurance products, benefit policy design, health or life insurance contract administration, regulatory, legislative or compliance administration, education, consulting, business administration or related field. Education - Bachelor's degree in liberal arts or related field OR four (4) years of experience in a directly related field. - High School Diploma or General Education Development (GED) required. License, Certification, Registration - N/A
Additional Requirements: - Basic knowledge of federal and state (Oregon and Washington) laws and regulations affecting HCSCs or other types of health insurance. - Working knowledge of the technical construction of contracts or other legal or technical manual types of documents. - Working knowledge of computer systems and MS Office, with demonstrated ability to effectively use word processing, spreadsheet, and presentation software. - Working knowledge of dynamics and trends in health insurance industry and products in addition to HMOs. - Excellent relationship development and change management skills - Demonstrated ability to instill confidence and respect in colleagues, develop constructive and productive working relationships with a variety of stakeholders and colleagues, gain cooperation and acceptance/approval in resolving problems, and negotiate mutually beneficial agreement between stakeholders. - Strong written and verbal communication and presentation skills, including the ability to clearly and concisely explain complex information to a variety of audiences. - Strong research and organizational skills, problem solving and critical thinking skills and ability to synthesize information from a variety of sources. - Ability to work independently and efficiently under pressure with exceptional and consistent attention to detail in a deadline-driven environment. - Demonstrated knowledge of project management principles and approach. - Proven ability to support colleagues and department objectives by learning new skills and demonstrated willingness to expand knowledge base.
Preferred Qualifications: - Minimum four (4) years experience in project management or consulting or related experience managing multiple workstreams. - Minimum five (5) years experience in the health care industry drafting and editing contractual documents. - Minimum one (1) year experience creating and submitting electronic filings via SERFF. - Minimum one (1) year experience with Medicare Advantage health plans. - Minimum one (1) year experience with a document management system. - Advanced expertise with standard Microsoft Office suite (including databases) and mainframe or custom-built computer programs and ability to learn new systems with minimal formal training. - Ability to understand and apply laws and regulations related to health care service contractors to contractual documents. - Ability to research and assess contractual issues in a regulated industry, exercising judgment as to when to escalate issues. - Strong interpersonal and communications skills (1:1, peer, team, presentations, written). - Ability to conduct, interpret and present qualitative analysis. - Excellent oral communication skills in a teleconference working environment. - Knowledge of Kaiser Permanente contracts, benefits, policies and procedures. - Advanced knowledge of federal and state laws and regulations affecting HCSCs. - Knowledge of Medicare Advantage health plans. - Understanding of OPM / FEHBP contracting and annual change processes. - Understanding of medical and/or dental terminology. - Understanding of health insurance benefits administration and/or underwriting concepts.
- Bachelor's degree in health care, public administration, business administration, liberal arts or other related field.
COMPANY Kaiser PermanenteTITLE Contract Coordinator IILOCATION Portland, ORREQNUMBER 631621
External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.