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About The Role

Brighton Health Plan Solutions is looking for an Implementation Manager with experience managing a complex, program of strategic projects that span organizational boundaries, manages multiple high-risk projects, including projects involving external vendors and multiple business areas that have a significant legal and/or financial impact to Company’s Business.  This individual should have hands on experience in setting and managing large complex projects in Healthcare Insurance across business, operational, and IT teams, spanning one or more work streams, including: Client Implementation, Enrollment & Eligibility, Claims processing & Reimbursements, Member/Provider self-service, Customer Service, Legal etc.  The individual will be an integral part of Implementation Team with the main objectives being on the installation of new clients and process improvement.

Primary Responsibilities

+ Responsible for the overall process and timely completion of tasks associated with the implementation of new and existing clients including development of operational workflows, identifying risks in the implementation process, developing internal communications, standard implementation project plans, obtaining and documenting client requirements, and preparing interdepartmental communications.

+ Serve as primary liaison and implementation coordinator for external clients throughout the implementation process.

+ Serve as the key liaison with business team and Information Technology departments on implementation management and resource planning.

+ Manage various file integrations including eligibility, accumulators, claims, etc.

+ Create an efficient process to manage client implementations and make appropriate recommendations for continuous improvement

+ Maintain and coordinate necessary documents relevant to each implementation

+ Coordination and fulfillment of Member/Client Communications such as creating announcements, creating Identification card drafts, announcement letters, etc.

Essential Qualifications

+ Bachelor’s Degree in Business Administration, Health Care Administration, Economics, Marketing, or related field.

+ 7+ years of implementation experience (with 2+ years in Healthcare Insurance preferably) in planning, development, implementation, and maintenance of process and systems.  Previous project management experience in a dynamic high-technology environment is a key to success in this position.

+ Knowledge and experience with working with and setting up EDI files, 834/837 files and SFTP sites.

+ Excellent verbal and written communication skills.

+ Ability to maintain effective relationships with internal and external project resources.

+ Ability to work autonomously in performing duties requiring extensive knowledge and understanding of the healthcare industry and project management.

+ Must possess excellent communication skills, in addition to, the ability to lead others and promote team building that supports and produces successful results.

+ Excellent time management, decision making skills, interpersonal skills and the ability to organize workflows to meet deadlines.

+ Advanced knowledge of the Microsoft Suite of tools such as MS project, PowerPoint, Excel, Word, etc.

+ Certified Associate in Project Management (CAPM) certification is preferred but not required.

About

At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you’ll become part of a diverse and welcoming culture focused on encouragement, respect and increasing diversity, inclusion and a sense of belonging at every level. Here, you’ll be encouraged to bring your authentic self to work with all of your unique abilities.

Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today’s healthcare with our flexible and cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider networks, and innovative technology platform. As a healthcare enablement company, we unlock opportunities that provide clients with the customizable tools they need to enhance the member experience, improve health outcomes and achieve their healthcare goals and objectives. Together with our trusted partners, we are transforming the health plan experience with the promise of turning today’s challenges into tomorrow’s solutions.

Come be a part of the Brightest Ideas in Healthcare™.

Company Mission

Transform the health plan experience – how health care is accessed and delivered – by bringing outstanding products and services to our partners.

Company Vision

Redefine health care quality and value by aligning the incentives of our partners in powerful and unique ways.

DEI Purpose Statement

At BHPS, we encourage all team members to bring your authentic selves to work with all of your unique abilities.   We respect how you experience the world and welcome you to bring the fullness of your lived experience into the workplace.  We are building, nurturing and embracing a culture focused on increasing diversity, inclusion and a sense of belonging at every level.

*We are an Equal Opportunity Employer

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