Plan Document Specialist
PacificSource

Portland, Oregon

This job has expired.


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PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.

Diversity and Inclusion: PacificSource values the diversity of the people we hire and serve. We are committed to creating a diverse environment and fostering a workplace in which individual differences are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.

Position Overview: Responsible for creation of all self-funded materials. Provide assistance with required client state filings specific to the self-funded line of business. Responsible for reviewing, compiling, coordinating, and communicating self funded plan document requirements for potential, new, and renewing large groups under the commercial line of business. Ensure accuracy and adherence to legal deadlines and support other departments in providing customer service. Provide contribution to the layout and design of documents

Essential Responsibilities:

  • Liaise with Legal and Compliance to analyze, revise, and manage technical documentation ensuring proper use of grammar and adherence to technical writing standards. Act as self funded specialist for document preparation and review.
  • Serve as a subject matter expert for plan document information. Communicate with multiple departments, and the market leads to ensure clear communication between all constituents.
  • Develop and maintain plan and agreement language for self-funded plan materials.
  • Coordinate with Communications on all custom self funded documents.
  • Set-up and communicate new and changing core plan document designs, requirements, and new formatting styles.
  • Maintain self funded plan materials from pre-filing (if required) through post-implementation, ensuring consistency in language and compliance with state, federal, and other regulatory entities per company policies and procedures.
  • Liaise with other departments in order to establish and maintain consistent language and operation requirements and support in relation to the organization's sales, materials management, production and overall operating functions.
  • Attend internal and external meetings as required.
  • Work to identify potential issues and seek resolution(s).
  • Serve as key internal contact to solve problems for document issues relating to plan documents, SBC's, ASO agreements, and amendments.
  • Identify process improvements for document creation and accuracy for all self-funded products sold or represented by PacificSource. Follow legal and compliance procedures for review of all self funded documents (Plan Document, Amendments, SBCs, and ASO Agreements).
  • Maintain job aids and train staff throughout the company on the self funded materials and new releases. Prepare and conduct educational meetings for specific departments as needed.
  • Prepare Plan Documents, Agreements, Plan Amendments, SBC's or other documents for internal and external use.
  • Support Legal and Compliance in the product filing process by reviewing and auditing forms for self funded filings including but not limited to stop loss contracts, plan documents and agreements.
  • Coordinate with sales and track all self funded materials to ensure that PacificSource receives signed required documents for self funded plans.
  • Evaluate returned documents to confirm all documents were received and are fully executed.
  • Publish plan documents, SBC's, amendments or other materials as required on web sites.

Supporting Responsibilities:
  • Meet department and company performance and attendance expectations.
  • Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
  • Perform special projects and other duties as assigned.

Work Experience: Minimum of five years of technical background experience in the health insurance industry specific to self-funded products. Must have a thorough understanding of self-funded services and products, administrative procedures, documents requirements and compliance within the health insurance industry.

Education, Certificates, Licenses: Bachelor degree or demonstrated equivalent work experience required.

Knowledge: A thorough understanding of insurance products, contracts, administrative procedures, and the health insurance industry's legal and mandatory guidelines preferred. Strong working knowledge of state and federal laws affecting ASO business lines. Ability to remain current on PacificSource administrative procedures and products, healthcare, and the health insurance industry.

Must possess excellent communication skills, particularly in writing and must be able to communicate and work effectively with a wide variety of internal and external customers. Ability to work under pressure and meet all deadlines. Ability to handle complex regulatory language to describe processes, functions and requirements under state, federal and PacificSource guidelines.

Must possess strong skills in Microsoft Word, Excel, and PowerPoint. Ability to consistently and effectively pay attention to detail, produce high quality work in a timely manner, and strive to increase production without sacrificing quality. Ability to handle sensitive issues with diplomacy and persuasiveness. Must possess strong analytical, planning, organizational, and time management skills

Competencies
  • Adaptability
  • Building Customer Loyalty
  • Building Strategic Work Relationships
  • Building Trust
  • Continuous Improvement
  • Contributing to Team Success
  • Planning and Organizing
  • Work Standards

Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately less than 5% of the time.

Our Values

We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:
  • We are committed to doing the right thing.
  • We are one team working toward a common goal.
  • We are each responsible for customer service.
  • We practice open communication at all levels of the company to foster individual, team and company growth.
  • We actively participate in efforts to improve our many communities-internally and externally.
  • We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
  • We encourage creativity, innovation, and the pursuit of excellence.

Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.

Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.


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