Job Details


Requisition Number 18-0041
Post Date 8/1/2018
Title Specialist, Health Services
Organization Concordia Plan Services
Job Grade 12
City St. Louis
State MO
FT/PT Full Time
Description

Mission and Vision

  • Concordia Plan Services ‘walks together’ with LCMS ministries in caring for workers and their families…so that the Word of God continues to spread!
  • Our 2020 vision is to transform CPS from being solely a benefits provider to the most widely recognized source of employer and worker-related solutions for LCMS ministries.

     

Reporting Relationships

  • Specialist, Health Services reports to the Manager, Health Services. 

 

Essential Job Functions

  • Serves as front line representative providing positive, knowledgeable contact for church workers and employers.
  • Acts as an advocate for the member when needed, and resolves questions and issues related to plan provisions.
  • Provides direction for the Health Services internship program, including program design, training, and supervision.
  • As a subject matter expert (SME), supports the Health Services team with an area(s) of specialized knowledge.
  • Provides direct feedback to department manager in identifying coaching and development opportunities for individual staff and provides solutions to gaps identified.
  • Engages in problem resolution for health plan members; serves as an operational liaison for health benefit vendors.
  • Assists in examining existing processes and proposes changes or enhancements to help CPS achieve health solutions goals.
  • Accesses vendor systems interface and provides internal support, coordinates with plan design team to implement changes, and provides quality assurance for eligibility file exchanges with vendors.
  • Assists the manager in interpreting the Concordia Health Plan (CHP) and ensuring proper application of benefits by vendors, employers and members.
  • Participates in special projects as defined by strategic plans and senior management.
  • Participates in a cross training opportunities within another Customer Experience department.
Requirements

Education and Experience

  • Bachelor’s Degree or equivalent experience, preferred.
  • 5+ years of experience in Health Services or closely related field.
  • Experience managing time-sensitive processes, deadlines, etc., with empathy and compassion.
  • Experience and strong acumen with applied business technology, preferred.
  • Professional benefits certification (CEBS, World at Work), preferred.

 

Competencies (Knowledge, Skills and Abilities)

  • Strong knowledge of Federal HIPAA regulations.
  • Intermediate knowledge and application of principles of Health Care Reform.
  • Strong analytical skills.
  • Intermediate project management skills, includes interdepartmental projects.
  • Understands benefit plans, functions and requirements within Operations, and key interactions among CPS departments/disciplines and related business systems.
  • Ability to design, develop and collaborate on communication materials.
  • Demonstrated ability to develop/implement processes and evaluate/improve process outcomes.
  • Command of system and collaborative tools (Pinnacle, SharePoint and Infor/Lawson), skilled in use of MS Office suite.
  • Ability to articulate information simply and concisely in person, over the phone and in writing, and to reflect CPS values in all internal and external communications. 
  • Demonstrates a high commitment to the organizational by applying concepts and principles of the Integrity Service program or similar values-based customer service program; is dedicated to meeting the expectations and requirements of internal and external customers.
  • Ability to navigate effectively in highly regulated industry and with complex organizations required; experience navigating LCMS structure and operations.
  • Sets clear goals and objectives, cooperates and participates fully in the coaching process, and actively seeks continuous learning to improve personal and team performance.
  • Participates fully on assigned and adjunct teams; fosters a collaborative spirit; builds collaborative networks with internal staff and vendor representatives.
  • Practices high level of confidentiality; serves as liaison with individuals in crisis. Ability to relate well with professional church workers, maintaining appropriate balance between compassion, encouragement, and accommodation in all interactions.
  • Interacts effectively with a wide variety of people; respectful and maintains the dignity of others; amicable; fosters differing opinions and values input from various perspectives.

 

Supervisory Responsibility

  • Specialist, Health Services does not have direct reports.
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