TPA Operations Manager (14201)

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Job description

JOB SUMMARY:

Lead the External Operations support team to insured delivery of a superior customer experience for internal and external stakeholders that meets Globe Life's processing, regulatory and oversight requirements.

PRIMARY DUTIES & RESPONSIBILITIES:

• Lead the Operations Team in providing strategic oversight of Third Party Administrators through the entire group lifecycle sold case process through renewal (including on-boarding, policy fulfilment, service, billing and commissions) to insure compliance, processing, service and reporting standards/requirements are met.


• Support TPA Operations Directors/Managers and Key Accounts Team in understanding and resolving complex service issues as they arise.


• Participate in regular and ad hoc meetings with TPA partners including weekly, bi-weekly and quarterly business reviews to support on-going development and improvement of administrator relationship and service levels.


• Using SLAs, business reports, annual audits and other key metrics, identify areas for TPAs to achieve incremental improvement in service levels and business processes. Develop, document and enact measurable action plans to address areas identified for improvement.


• Monitor TPA compliance with risk management activities, such as mandatory annual training for TPA personnel, and quarterly/annual risk reviews and reporting.


• Document and distribute procedures, policies and regulations to insure consistent delivery of Globe Life products and services.


• Work with CEO and Internal Operations to ensure that TPAs and the TPA Operations team are in compliance with SOX and underwriting control standards, claims control standards, and other standards related to customer relationship management.


• Lead development and maintenance of key external documentation/communication including Employer Guide, Producer Guide, business process documents and similar guides for third party partners and customers.


• Provide senior management support, as needed, to complete and deliver RFPs for key accounts and provide technical support at finalist presentations, as requested by CDO.


• Collaborate with internal Operations on product filing and implementation projects.


• Ensure all interactions with customers are focused on delivering a fair outcome, including having the right products for their needs.


• Contribute to an environment of teamwork and promote a positive brand image to our external customers.


• Carry out additional responsibility as individually notified, either through your objectives or through the learning management system.

Required Skills:

KNOWLEDGE, SKILLS & ABILITIES:

• Understands business strategy and the work of the other departments within the organization and able to work with multidisciplinary teams in order to define requirements and/or deliver a project successfully


• Sees the big picture and successfully develops plans to guide strategic initiatives through to implementation


• Solid background and experience with group administrative platforms and billing including complex case installation and complex issue analysis and resolution.


• Solid understanding of group insurance and supplemental/voluntary insurance industry


• Well organized and efficient; detail oriented; proficient at documentation


• Professional presentation skills


• Proficient with internet research skills and Microsoft office tools


• Managing resources effectively


• Industry and product expertise, including finance and risk-management


• Problem solving; systemic process evaluation and improvement


• Purposeful communication and proficient customer-facing communication skills


• Broad-based thinking; Business Awareness; Corporate thinking


• Team Leadership/Coaching Skills (with both internal and external stakeholders)

Required Experience:

EDUCATION & WORK EXPEERIENCE REQUIRED:

• Bachelor's Degree or equivalent experience


• Minimum of 5 years of experience in Group Insurance environment in a management role


• Minimum of 10 years' experience with Group Insurance products, financial /underwriting perspective, group administration, all aspects of external customer service, and working knowledge of product policies, state filings, and contracts.


• Previous experience working with Third Party Administrators, third party outsourcing and vendor management required


• Proven track record of leadership in all aspects of TPA relationship management and administration systems platforms and automation, including online UX and UI.


• Proven knowledge of group insurance products, group underwriting principles, product cycles, claim trends, and loss ratios.


• Detailed working knowledge of all aspects of on-boarding new business, customer service, billing, policy issue, commissions, and contracts.


• Experience and understanding of enforcing industry, state, and federal compliance with marketing communication, sales support, and all customer interactions.


• Management experience to demonstrate multi-disciplinary team collaboration.

- provided by Dice