Healthcare Platinum Relationship Manager

We are currently seeking a Platinum Relationship Manager to join our great team in San Francisco. The office is located at the corner of 4th and Mission in the heart of downtown San Francisco and is just one block from BART. This is a great opportunity to work in a friendly, business casual environment, where the team has a long-standing, positive relationship servicing a large multi-state client. Also, this office provides a small company feel (approximately 60 employees in this office location) combined with the stability of a large company. 

 

The PRM will serve as the primary point of contact with Benefit Plans Office, ILWU, and PMA representatives for claim and customer service related questions and problems. Monitors plan and benefit changes, serving as the subject matter expert for the service center. Conducts problem solving, root cause analysis, and gap analysis, involving Service Center units and key Healthcare departments as needed.

Primary Responsibilities Conducts research and provides resolution to claims and service related questions and problems by identifying the root cause of the problem, involving appropriate parties, facilitating resolution of the issue and communicating back the actions taken to bring closure to the inquiry. Resolution may include personally processing or adjusting claims. Provides a single source of contact while building relationships with key client representatives providing heightened attention and expeditious resolution of inquiries. Acknowledgement of all inquiries must occur within 24 hours, with average resolution time of 48 hours. Screen and direct incoming correspondence for Service Center; direct problems/inquiries to appropriate person(s), and follow-up to ensure problem resolution. May also involve responding to incoming correspondence and creating non-routine and confidential correspondence. Works closely with Service Center units, Claims Vendor staff, and Home Office departments to successfully implement plan or benefit changes. This requires knowledge of service center capabilities and a thorough knowledge of benefit plan design. As directed, participates in client conference calls, meetings & presentations. Work with Director to assess and improve performance of Service Center. This includes special projects which may require independent research, data collection, interviews, and/or analysis. Acts as a subject matter expert for claims and customer service related questions. Must stay current on all policies and procedures. Reviews all policy specific information, and ensures that appropriate reference materials are kept updated.

Background and Qualifications Associate's degree in business related field preferred, or equivalent work experience. Minimum 5-6 years directly applicable group claims and customer service experience. Comprehensive industry knowledge and ILWU-PMA benefit plans knowledge essential. Ability to shift priorities as business demands change. Excellent oral and written communication skills. Quality focused with ability to balance the workload. Ability to maintain confidentiality crucial.

On April 1, 2008, Connecticut General Life Insurance Company (CG Life), a subsidiary of CIGNA Corporation and the primary operating company in the CIGNA HealthCare division, purchased the health care business of Great-West Life & Annuity Insurance Company, known as Great-West Healthcare. Between April 1, 2008, and approximately July 1, 2008, Great-West employees involved with Great-West's health care business will provide services to CIGNA HealthCare. If you become such a Great-West employee during this interim period, you will receive a separate offer of employment with CG Life. After the interim period, Great-West employees who accept CG Life offers of employment will become CG Life employees. For more information, please visit Great-West Life & Annuity at www.greatwest.com. We are equal opportunity employer dedicated to workforce diversity. We are committed to providing a drug-free workplace.

You'll find good people at Great-West.