Plan Design Specialist works closely with clients to design group health, dental and/or life insurance plans to create an overall benefit package. Works alongside underwriters, but is not an underwriter role. Being a Plan Design Specialist monitors and analyzes cost trends. May handle more complex plan design. Additionally, Plan Design Specialist requires a bachelor's degree or its equivalent. Typically reports to a supervisor or manager. The Plan Design Specialist gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Plan Design Specialist typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.
Job Summary:
Responsible for the daily supervision and operations of the Prior Authorization Specialists. Develops training, trains staff, assigns work, implements policies and procedures, and resolves complex issues to ensure accurate and timely management of prior authorization requests. Maintains compliance with state and federal requirements. Performs quality assurance audits. Implements and monitors productivity and efficiency reporting and adjusts workflows/staffing as needed. Supports the Director in day to day operations and focused initiatives. Functions as the liaison between providers and Plan staff as it relates to authorizations.
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About WellSense
WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances.
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0 Plan Design Specialist jobs found in Norwich, CT area