Admin Clerical-Subject Matter Expert-Contractor
: Job Details :

Additional Job Details Hiring Manager: Monique L. Fisher Do you have a Pre-Identified Candidate?: No Is this manager a Do Not Contact?: No Distribution Route (Team Track/Standard Distribution): TEam Track Expected Bill Rate to KP (with MSP Fee): (***) Office Location (if remote, please provide the KP Site address): 1840 California Ave. Corona, Ca. 92883 Any Travel for this role?: No o Percentage of Travel? 0% o Specific Details around travel including locations, frequency, different locations throughout the same day, etc. N/A Remote Options (Fully Remote, Partially Remote, KP Onsite): o If Remote: Will the worker need to be Remote local to the office or Remote anywhere in the US: Yes o If Onsite (please note if the worker is onsite, they must be vaccinated before starting the role): Parking Situation: N/A Dress Code: N/A Required Level of Education: Bachelor s degree or four (4) years of directly related experience required. Preferred Level of Education: Bachelor s Degree or four (4) years of directly related experience required. How many years of related experience are you looking for in your ideal candidate?: Minimum of six (6) years in a health care, health insurance, or sales and marketing environment. Minimum of three (3) years working directly with customers by phone, email and/or in person providing information and resolving issues. Specific Systems Knowledge Required: Basic working knowledge on computer, Word, Excel, OneNote, Outlook, and Teams, etc. Specific Systems Knowledge Preferred: N/A Any Required Certifications?: N/A Expected Shift: 8:00 a.m. 5:00 p.m. GL String: 0315-30000-6064 Interview Process: Panel Interview conducted virtually via Teams FDA approver: Monique L. Fisher first level Top Three things Worker will be doing: Responding to customers, brokers, and Sales & Account Managers via email and telephone fielding complex inquires and issues and working to resolve customers requests and issues. Top Three Skillsets needed: Strong Customer Service Skill, Strong Organizational Skills, Ability to research and resolve complex issues independently with minimal assistance Anything else important we need to know to fill your role?: The Employer Services Specialist supports growth and retention of members across the enterprise including both Regional and National lines of business as necessary by: 1) Providing one-contact resolution to escalated employer, consultant and broker concerns that requires the application of considerable discretion and independent judgment to evaluate various courses of conduct, formulate solutions, and negotiate resolution that binds KP and departs from prescribed standards 2) Analyzing patterns and trend data regarding employer, consultant and broker concerns and needs 3) Formulating recommendations to improve and sustain effective purchaser relationships. Please confirm this is the correct Job Description: See Job Summary & Essential Responsibilities below Job Summary: The Employer Services Specialist supports growth and retention of members across the enterprise including both Regional and National lines of business as necessary by: 1) Providing one-contact resolution to escalated employer, consultant and broker concerns that requires the application of considerable discretion and independent judgment to evaluate various courses of conduct, formulate solutions, and negotiate resolution that binds KP and departs from prescribed standards 2) Analyzing patterns and trend data regarding employer, consultant and broker concerns and needs 3) Formulating recommendations to improve and sustain effective purchaser relationships. Essential Responsibilities: Retention and Growth Opportunities: Identify growth and benefit expansion solutions to better meet purchaser health care needs. Report trends around issues groups are experiencing to the account management team to inform strategic account engagement and renewal planning. Positions the organization to ensure optimal membership growth, and to meet retention targets. Research and Resolution of Employer, Broker and Consultant Initiated Issues: Formulate solutions to complex and sensitive employer, consultant, broker-initiated concerns, using considerable discretion and independent judgment. Investigate circumstances surrounding purchaser issues and evaluating various courses of conduct. Negotiate reasonable and contractually defensible resolution of purchaser issues by weighing conflicting information (regulations, legal principles, and regional goals), departing from prescribed standards and binding KP. Troubleshoots emerging issues, summarizes information, and works with relevant stakeholders to provide the leadership team with the information needed to make sound decisions. Issue Entry and Documentation: Log issues received and maintain updated status of resolution in the system of record. Ensure accurate and complete data is entered into the correct business applications. Process Improvement and Data Analysis: Identify, analyze, and report trends and/or systematic issues as they become apparent. Collaborates with internal stakeholders to effectively meet the needs of external consumers (members, groups, consultants, brokers). Provide consultation and recommendations to management around process improvement opportunities solutions. With limited guidance coordinates the collection and validation of business requirements for process improvement initiatives. Knowledge and Professional Development: Complete required training around health plan products and processes. Stay current on applicable laws and regulations. Pursue opportunities to continuously develop skills. Demonstrates ability to collaborate with management to support team member training and development opportunities.