Policy Management Executive

JOB PURPOSE
The job holder is responsible for updating policy records in the internal system to ensure the group policy is showing the correct status and level in order for the members to have access to care. He/She will be responsible for the end-to-end Account Installation process including setting up of benefits, group details, contacts, rates, pricing, member records and card requirements.
2. RESPOSIBILITIES AND DUTIES
- Interacts with different internal departments and partners in the coordination and implementation of our new and renewing accounts to effectively setup benefit plan, group and member information.
- Establishes and complies with a client specific service plan.
- Ensures that the documentation received is complete and logical as per system requirements.
- Reviews the Table of Benefits for acceptability / consistency from system requirements.
- Reviews the member census received for new policies as per regulatory compliance and system requirements.
- Reconciles census against system active list for renewal policies.
- Request for additional information based on system and compliance requirements.
- Set up benefits in the system and all its other linkages.
- Set up system with group and member details.
- Responsible for releasing member welcome pack for newly installed policy and renewed policies.
- Ensure that the group policy setup has successfully been created from partner’s system.
- Reconcile accuracy between internal and partner’s system before releasing member cards.
- Reviews mid-year policy changes and updates system as required.
- Ensure that the output required for the mid-year policy change has been coordinated within teams and released as required.
- Acts as an intermediary between internal departments and business partners in resolving daily service issues related to newly incepted/renewed group.
- Acts as Subject Matter Expert for any system related query for policies.
- Researches and resolves issues in day-to-day operations.
- Performs daily, weekly, monthly reconciliation between systems.
- Performs routine maintenance, report preparation and issue resolution with efficient book of business management through timely and proper utilization of internal tools.
- Performs other duties as assigned and maintains high quality of work.
- Provides the highest levels of services in Policy Administration.
- Monitors and manage team queue, workflow and quality of work.
- Build relationships with internal departments and partners to ensure smooth processing of client requests.
- Identifies potential process improvements and make recommendations to the organization.
- Actively support team members and provides resource to enable all team goals to be achieved.
- Responsibility and accountability for service levels, turnaround times and quality.

3. QUALIFICATIONS
- Bachelor’s degree
- 2 to 3 years of experience with data entry, preferably in Medical Insurance
- Analytical skills - must be able to review data and identify any potential issues or discrepancies
- High attention to details.
- Must be able to conduct computer data entry.
- Must be able to make recommendations which are supported by various data pulls
- Intermediate proficiency in Microsoft Office Suite specifically in Excel.
- Excellent written and oral communication skills.
- Proven ability to work independently as well as a productive member of a team.
- Exceptional organization and time-management focus.

4. COMPETENCIES
- Conflict Management - Sees opportunities within conflicts arising; reads situation quickly; engages in focused listening; can hammer out tough agreements and settle disputes equitability; can find common ground and get cooperation with minimum disruption.
- Customer Focus - Is dedicated to meeting the expectations and requirements of internal and external customers; Gets first-hand customer information and uses it for improvements in products and services; Acts with customers in mind; Establishes and maintains effective relationships with customers and gains their trust and respect

About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.