The mission of Washington Health Benefit Exchange (Exchange) is to radically improve how Washington residents secure health insurance through innovative and practical solutions, an easy-to-use customer experience, our values of integrity, respect, equity and transparency, and by providing undeniable value to the health care community.
The Exchange is a public-private partnership that operates Washington Healthplanfinder, the eligibility and enrollment portal used by one in four Washington residents to obtain health and dental coverage. Through this platform, and with support from a Customer Support Center and statewide network of in-person navigators and brokers, individuals and families can shop, compare and enroll in private, qualified health plans (as defined in the Affordable Care Act) or enroll in Washington Apple Health, the state Medicaid program.
The Exchange embraces the following equity statement adopted by our Board of Directors:
Equity is fundamental to the mission of the Washington Health Benefit Exchange. The process of advancing toward equity and becoming anti-racist is disruptive and demands vigilance to dismantle deeply entrenched systems of privilege and oppression. While systemic racism is a root cause of many societal inequities, we must also use an intersectional approach to address all forms of bias and oppression, which interact with and often exacerbate racial inequities. To be successful, we must recognize the socioeconomic drivers of health and focus on people and places where needs are greatest. As we listen to community, we must hold ourselves accountable to responding to recommendations to remedy inequitable policies, systems, or practices within the Exchange’s area of influence. Our goal is that all Washingtonians have full and equal access to opportunities, power and resources to achieve their full potential.
SUMMARY
The Enrollment Analyst is responsible for processing the enrollment life cycle between the Washington Health Benefit Exchange and insurance carriers to ensure customers are enrolled timely and accurately into the health and dental coverage they have selected through Healthplanfinder. This position will conduct comprehensive end-to-end analysis and reconciliation of enrollment data and transactions wielding multiple reconciliation tools and systems, aligning Healthplanfinder and carrier enrollment systems. This position will also conduct comprehensive end-to-end analysis of individual applications, conducting direct outreach as needed to insurance carriers, customers, and external agencies to resolve highly complex and often sensitive customer escalations (including from the Office of the Insurance Commissioner and Governor’s office).
The Enrollment Analyst will represent the Enrollment Team and serve as a direct liaison to carrier partners, external agencies, and/or internal teams. This position will identify and support resolution of defects and gaps in carrier and Exchange enrollment systems. It will also identify improvement opportunities in reconciliation processes and the customer experience, supporting implementation of solutions at the Exchange and with carrier partners.
DUTIES AND RESPONSIBILITIES
- Serve as a Healthplanfinder expert and provide advanced enrollment support in a timely fashion to insurance carriers, customers, external stakeholders, and internal teams, including in-depth knowledge and understanding of the Healthplanfinder application, eligibility, enrollment, and reconciliation.
- Conduct comprehensive analysis and reconciliation of enrollment data using Healthplanfinder and reconciliation systems and tools.
- Responsible for building and maintaining relationships by serving as an Enrollment liaison to carrier partners, internal teams, and/or external stakeholders. Participate in meetings, respond to phone and email inquiries, conduct on-site visits, engage in ad-hoc projects, and collaborate to improve enrollment operational processes and the customer experience.
- Conduct daily, weekly, and monthly reconciliation activities to ensure enrollment accuracy in Healthplanfinder and carrier systems, including processing reports and meeting with carrier partners and internal teams.
- Identify trends in enrollment and application data indicative of larger Healthplanfinder or carrier system or process issues.
- Conduct comprehensive analysis, investigation, and direct outreach to customers, insurance carriers, and external agencies to promptly resolve complex and sensitive customer escalations with respect and compassion.
- Collaborate with other departments, teams, and subject matter experts as needed to quickly and accurately, address the needs of Healthplanfinder customers, including in urgent or high-risk situations.
- Provide verbal and/or written analysis that is concise, audience-appropriate, professional, and articulate in response to urgent carrier requests, executive escalations, and escalations from government entities.
- Provide in-depth case and system analysis; recommended solutions and workarounds, including data fix suggestions that meet the needs of business and IT.
- Maintain confidential client records, statistical data, and tracking information; submit required reporting information in a complete, accurate and timely manner.
- Participate in process improvement groups and Healthplanfinder enhancements within Operations.
- Work on special projects/other duties as assigned.
QUALIFICATIONS
Required:
- Bachelor’s degree and three years of experience in any of the following:
- Conducting analysis to assist clients with complex issues and service needs in a social service, healthcare, or health insurance setting; or
- Conducting analysis and utilizing systems and tools to reconcile and correct large volumes of data.
- Additional experience may substitute, year for year, for education.
- Ability to maintain high level of confidentiality.
- Excellent written and verbal communication skills with the ability to communicate effectively regarding complex or sensitive information or issues.
- Strong analytical, problem-solving, and critical thinking skills.
- Demonstrated ability to earn the trust, respect, and confidence of co-workers, carriers, external stakeholders, and customers through consistent honesty, forthrightness, responsibility and professionalism in all interactions.
- Strong interpersonal skills; ability to work with diverse client populations, as well as all levels of internal management and staff.
- Organized, flexible, proactive, resourceful, and efficient with a high attention to detail that culminates in clear documentation and swift, accurate account work.
- Motivated and positive team player with a can-do attitude.
- Ability to manage a diverse, complex workload and balance multiple priorities while communicating progress.
- Ability to maintain a strong internal and external customer focus.
Desired:
- Broad knowledge and understanding of the health care industry, including the commercial insurance market, Medicaid, or other health delivery systems.
- Proficient in Microsoft Office, especially Excel.
- Familiarity with HIPAA 834 enrollment transactions, Edifecs, or other enrollment data and systems.
- Familiarity with Washington Healthplanfinder or other Exchange portals used to obtain health or dental coverage.
- Self-starter with initiative to creatively and proactively problem solve. Applies independent judgment to make decisions and take action, with a willingness to accept responsibility for your actions.
APPLICATION INSTRUCTIONS
This position will be open until we find a suitable number of candidates to review. If interested, please submit an application (Click the link) as soon as possible. The Exchange reserves the right to close the recruitment at any time.
SALARY INFORMATION
Full Salary Range: $54,166.00 to $81,250.00 annually, with midpoint at $67,708.00.
Hiring Range: $62,291.00 and $67,708.00 annually. This is an estimate of where a qualified candidate can expect to receive an offer.
The actual salary offer will consider candidate experience, skills, qualifications, internal equity, and the market. Our compensation policy reserves the salary range above the midpoint for employees who are meeting and exceeding expectations and for growth and development, up to the maximum.
BENEFITS
Take a peek at our benefits package.
WORKING CONDITIONS
Core business hours are 8:00 a.m. to 5:00 p.m., Monday through Friday. There are times where irregular hours will be required. The preferred duty station is our Olympia, Washington headquarters. The nature of this role relies heavily on remote and in-person collaboration. While a hybrid remote and on-site schedule may be considered, the position will require flexibility to allow for in-office availability as business needs dictate. Travel requirements will be limited, however there may be occasions where an employee is required to travel and work irregular hours to attend meetings or trainings. Duties of this position require the use of standard office furniture and equipment, including setup for remote work. The employee is responsible for providing and maintaining a safe, ergonomic, and secure workspace at their remote location.
The working conditions and physical demands are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
SPECIAL REQUIREMENTS
A criminal background screen will be conducted for candidates under final consideration, and if hired, every five years of employment where highly sensitive data is processed or maintained by the position. The result of this background screen must meet the Exchange’s eligibility standards.
OTHER INFORMATION
The above statements are intended to describe the general nature and levels of work being performed. They are not intended to be construed as an exhaustive list of responsibilities, duties and skills of personnel so classified.
This is not an employment agreement or contract. Management has the exclusive right to alter this job description at any time without notice.
The Washington Health Benefit Exchange is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, marital status, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
We participate in E-Verify. You can view the Department of Justice's Right to Work poster here.
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