Help Wanted

HELP WANTED

HealthPlan Integration Specialist

If you want to be a part of a place that provides nothing less than extraordinary compassionate care, then Adventist Health System is the place for you!

 

We are currently seeking qualified candidates for a Health Plan Integration Specialist position that will be based in our Population Health department.  This position is based in Orlando, FL.

 

This position has the opportunity to be responsible for assisting the Director in operating AHS’ insurance partnership with Health First Health Plans and its affiliates under the brand name Florida Hospital Care Advantage (FHCA).  The Specialist guides, and coordinates all major FHCA operational activities and directly performs or facilitates many of the component activities necessary to accomplishing FHCA’s major priorities.  As the partnership grows and matures, the Specialist’s duties will be continually evolving, old actions being dropped and new ones being added.

 

Specific job duties include:

  • Develops and maintains the FHCA Operational Action Plan used for monitoring all significant FHCA activities.
  • Implements a process for identifying, resolving and/or escalating issues that present a risk to important FHCA objectives and/or timelines. Leads in resolving issues directly where possible.  Discerns critical issues and exercises judgment in escalation to senior leadership.
  • Maintains various tools for managing the partnership, updating them monthly and as necessary.Takes the lead for AHS in arranging all FHCA governance meetings and any special meetings necessary for responding to issues as they arise.
  • Provides FHCA views or guidance to Network Operations in managing complex or politically sensitive provider issues related to FHCA administration.
  • Learns and takes ownership of the process to obtain access to electronic medical records and other AHS software systems for Health Fist users.  Regularly verifies needed access.  Acts in conjunction with the Help Desk as necessary in troubleshooting/escalating access problems.
  • Ensures AHS marketing team provides input in a timely manner on all marketing pieces sent by HF for approval by monitoring due dates, sending reminders.  Updates the marketing materials inventory and identifies gaps.
  • Updates the group sales pipeline weekly.
  • Gathers issues for other meeting agendas. 

Education Requirements:

  • Bachelor’s degree in Business Administration, Technology or Healthcare-related field, or 5 years in lieu of degree, required.

Experience Requirements:

  • Minimum of three years of experience in health insurance operations or provider network operations, required.

If this position sounds like a great match for your skills set and experience, please send your resume to Michelle Perez at Michelle.Perez@ahss.org.


 

Bouchard Insurance – Group Benefits Account Manager position available

The Group Benefits Account Manager should be knowledgeable about the renewal and retention of Health and Welfare plans, customer service oriented and a team player. This individual must have experience in managing group benefit accounts through all phases to include marketing, implementation, communication and enrollment, and must be willing to participate in self-development.  They must be able to organize time and work, keep up-to-date with changes within the industry and cultivate relationships with our partner carriers. Knowledge of fully insured and self-insured products and alternative funding methods and thorough comprehension of ancillary products is highly preferred.  Sagitta/Benefit Point experience a plus.  Bouchard offers a competitive salary, bonus structure and a great benefits plan.  We are actively hiring in the Orlando area as well as Clearwater and Sarasota locations.  For more information contact Lori Johnson, Corporate Recruiter at Bouchard Insurance at 727-373-2931, lorijohnson@bouchardinsurance or www.bouchardinsurance.com careers page.