Project Manager, Product Operations, KPIC Administration and Operations Job in Oakland, California US
Project Manager, Product Operations, KPIC Administration and Operations
The Manager, Product Operations supports KP's administration of insurance products in order to positively impact employer/member/provider experiences with KPIC insurance products. The Manager, Product Operations, reports to the KPIC Director of Product Operations, and is responsible and accountable for supporting all KPIC operational activities within an assigned Region(s). This position identify's, develops and implements process improvements to support administration of KPIC benefit plans across all KP Regions. In addition to Region specific responsibilities, the Manager, Product Operations also assumes ownership of one or more functional area's necessary to maintain KPIC in good standing with regulatory agencies and to ensure adherence to all applicable federal, state and local laws and regulations as well as KPIC's corporate policies and procedures. Provide claims and customer service support and education for a wide range of customers, including KPIC members, employer groups, regional sales account management, and both National and Regional product development and management. Provide project management services for the implementation of new KPIC products, processes and administrative platforms. Serve as indemnity insurance subject matter experts in the development, implementation and ongoing oversight of KPIC products at industry standard or better levels of performance. Manage and oversee the identification, documentation and resolution of escalated issues in support of KPIC products and regulatory requirements. Performs in depth root cause analysis to determine process improvements necessary either w/in KP or at contracted vendor. Serve as a key team member in the management of Operations department responsibilities and accountabilities, e.g. documentation of policies and procedures, grievance and appeal documentation; respond to department of insurance requests for assistance, and special investigative unit activities. Qualifications: Basic Qualifications: 8-12 years related experience. Regularly contributes to the development of new concepts, techniques and standards Considered functional expert in multiple fields Employs expertise as a generalist Strong customer service orientation for both internal and external customers Displays or expresses genuine desire to help or serve others and meet their needs Listens actively and demonstrates sensitivity to customer encouraging them to discuss concerns, interests, needs and difficult issues Consistent monitors own work and seeks further experiences to ensure continual quality service delivery Seeks information about underlying needs of members/customers Capable of defining and articulating strategies and changes based on impact on customer/member satisfaction 8-12 years prior experience in product operations 8-12 years customer/vendor management 8-12 years health insurance, health plan administration, healthcare benefit administration or benefit policy experience 4 year degree in related field or equivalent work experience