Plan, direct and coordinate all activities associated with HAP's Membership and Billing and Customer Services Departments. Track and report all member related activity for HAP's enrolled population throughout the entire HAP system.
Principal Duties and Responsibilities:
Provide general direction to the Membership and Billing and the Customer Services Departments, including the planning coordination and development of functions that impact divisional and corporate goals, strategies and objectives.
Evaluate administrative functions and devise qualitative and quantitative methodologies to improve cost and resource allocation and service.
Serve as Corporate Liaison to the Customer Services Committee of the HAP Board of Directors.
Review departmental budgets and develop a broad based divisional budget strategy incorporating both long and short term corporate objectives.
Maintain on-going interaction with the Health Plan Medical Director or designee to provide for the resolution of sensitive subscriber problems relating to HAP providers, policies and procedures.
Advise staff legal affairs department regarding subscriber litigations, their potential impact, and suggest appropriate means of resolution.
Act as a catalyst in the development of consistent, comprehensive policies regarding member benefits administered by the Health and Medical Affairs Division.
Development of Service Excellence policies and procedures in accordance with other corporate areas and HFHS relative to the entire HAP population.
Perform other duties as assigned.
Bachelor’s Degree in Health Care or Business required. Master’s degree in health care or business or related field preferred.
Minimum of Five (5) to ten (10) years in health care or insurance related industry.
Three (3) years in a managerial position.
Familiarity with organized labor groups preferred.
? Business Literacy: Knows the business and produces results; is aware of the financial implications of decisions made; identifies and seeks opportunities to enhance cost savings; builds on existing market strengths; and seizes ways to improve market penetration.
Change Leadership: Creates a motivating environment to successfully help people through change in a positive manner; fosters open communications, continuous improvement, and innovation; minimizes complexity; maintains stability; involves others in decision making.
Decision Making: Seeks and organizes information; develops and considers alternatives; takes or initiates action; draws upon personal experiences.
Effective Communications: Listens; freely shares information in a timely manner; clearly communicates messages, either verbally or in writing; checks for understanding; effectively delivers and receives difficult messages.
Performance Management: Involves people in improving organizational effectiveness in the accomplishment of its mission and goals; plans work and sets expectations; develops the capacity to perform; monitors performance; evaluates performance; recognizes and rewards good performance.
Quality Orientation: Embraces continuous improvement in the development of high quality products to deliver service excellence; utilizes technology improvements, value-added products, customer responsiveness; influences positive employee attitudes.
Relationship Building: Acts with integrity; maintains mutually beneficial relationships with customers, superiors, peers, team members, other departments and functions to achieve organizational goals.
Service Excellence: Intentionally and consistently provides impeccable service to internal and external customers; successfully delivers on service promises at every opportunity.
Strategic Thinking: Translates vision, strategy and long range goals into terms others can understand and establishes concrete plans to deliver customer satisfaction; leads by example.
Talent Development: Identifies the professional learning and development needs of self, and team members if appropriate; collaboratively plans development activities to improve on-the-job performance; emphasizes the importance of lifelong learning and continuous improvement.
Technical Expertise: Seeks solutions; has personal energy; demonstrates ability to get the job done; overcomes obstacles; focuses on accomplishments rather than activities.
Health Alliance Plan (HAP) is a nonprofit, regional health plan headquartered in Detroit.
Our mission: “to enhance the health and well-being of the lives we touch.”
HAP excels in delivering award-winning disease management, wellness and community outreach programs, and highly personalized customer service.
Henry Ford Health System Alignment:
• HAP is a subsidiary of Henry Ford Health Sys...tem, one of the national’s leading health care systems and a proud recipient of the 2011 Malcolm Baldrige National Quality Award for performance excellence and innovation.
• HAP serves an important role in promoting system integration and care coordination and acts as a catalyst in forming innovative patient care, community, business and economic partnerships. As the voice of the customer, HAP partners with HFHS to improve quality while maintaining a focus on value, affordability and accessibility.
• HAP has more than 1,300 employees in Detroit, Southfield, Flint and Grand Rapids.
• We serve more than 650,000 members through six product lines:
o Group Insured Commercial: PPO, EPO and HMO; Health Engagement programs offer employees incentives to adopt a healthier lifestyle.
o Individual: HAP Personal Alliance PPO, HSA and Short-Term health plans are for individuals and families not covered through employer health insurance.
o Medicare Solutions: HAP Medicare Solutions offer PPO and HMO plans, prescription drug plans, and Medicare Supplement plans for individuals and employer-sponsored retirees.
o Medicaid: HAP Midwest Health Plan has about 10,000 Medicare and Medicaid enrollees.
o Self-Funded: HAP and ASR Health Benefits offer competitive options for Michigan companies and health and welfare funds seeking to self-fund their health benefit costs.
o Network Leasing: Statewide PPO network that can be administered by Third Party Administrators and Welfare Funds