Executive Director, Health Administration Position Available In Westchester, New York

Executive Director, Health Administration Confidential West Harrison, NY 10604

• Hybrid work Our organization seeks a dynamic, collaborative and consultative executive to join its leadership team.

This position would report directly to the Senior Leader of Third Party, Health Administration Services who is responsible for managing client relationships and day-to-day operations of several areas. Externally, this position has relationship management responsibilities and advises clients on all aspects of health plan design and administration as well as provides critical consulting with respect to union collective bargaining. Internally, this role interfaces with various departments in the ongoing management of the business, including Finance, Legal and Eligibility and Collections. This role is located in White Plains, NY, and the incumbent will be expected to report to the office daily. Essential Duties and Responsibilities include, but are not limited to:

• Oversee and assist in day-to-day operations of the following departments: Customer Service, Appeals, Provider Relations, Claims, Subrogation, Service Representatives, and Communications.
• Support the administration of health-related services to various clients.
• Actively participate in both the RFP and presentation processes.
• Assist with new corporate initiatives and implementations.
• Monitor employer contract renewals and all union and employer relationships. Provide consulting advice and expertise to employer and union negotiators on issues of pricing and plan design which arise during collective bargaining.
• Manage all outside HMO Plans.
• Responsible for ongoing discussions with client vendors such as Anthem, CVS, Delta Dental, and VSP.
• Responsible for ongoing communications with outside legal counsel, auditors, actuaries, and investment consultants.
• Connect with internal departments regarding all required Fund functions such as Legal, Implementations, Finance, Appeals, Collections, Auditing, (Eligibility and Invoicing) and COBRA departments as needed.
• Oversee the following processes: annual Open Enrollment, member ID card production and distribution, and annual preparation of the Summaries of Benefits and Coverage (SBCs).
• Approve all client expenses for payment.
• Troubleshoot and provide solutions to escalated issues from the union or an employer, such as member eligibility and claims problems.
• Organize and prepare all documentation presented at client Board meetings. Present administration reports and recommendations at Board meetings.
• Examine the efficiency of the operation and suggest and implement changes to improve overall performance.
• Develop and manage departmental budgets.

Experience needed:

• Deep understanding of health benefits and health plans (10+ years insurance industry experience).
• Knowledge and familiarity with ERISA, ACA, HIPAA, COBRA, FMLA and similar federal regulations, as well as regulatory compliance updates.
• Ability to utilize multiple internal systems for research and troubleshooting.
• Management of a team of at least 5 individuals.
• Demonstrated ability to communicate clearly, concisely, and persuasively, both orally and in writing.
• Demonstrated negotiation and advisory skills/experience.
• Direct leadership experience and oversight of health-related operations.
• Strong organizational skills with great attention to detail.
• Multi-tasker who responds quickly to change with a high sense of urgency.
• Strong work ethic and a “roll-up-your-sleeves” mentality.
• A strong ability to execute and deliver on goals and action plans resourcefully. Education and Certification/License Credentials
• College degree

Job Type:

Full-time Pay:

$125,000.00 – $150,000.00 per year

Benefits:

401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Tuition reimbursement Vision insurance

Schedule:

Monday to Friday Ability to

Commute:

West Harrison, NY 10604 (Required) Ability to

Relocate:

West Harrison, NY 10604: Relocate before starting work (Required) Willingness to travel: 25% (Preferred)

Work Location:

Hybrid remote in West Harrison, NY 10604