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Program Implementation Representative
in Arlington VA
We are looking for a strong who has Health and Welfare Plans &/or Retirement experience to join our mission driven, not-for-profit “Best Place to Work” recognized organization. As a member of the Benefit Implementation team, you
will play a critical role to ensure the Health & Welfare Plans and Retirement changes to our member cooperatives plans are accurately updated in our internal systems. You’ll play an integral role in the setup and ongoing administration of our
Responsible for developing and facilitating processes to handle the integration and flow of co-op enrollment and plan information for all Group Benefit plans and programs
(medical, prescription, vision, dental, life, disability) to multiple systems. This relates to all plan activities including the annual renewal process, plan conversions, new plan implementations,plan changes, split/mergers and Health ID cards. Relative to
Business Process Evaluation, defines and analyzes existing business processes and process workflows and implements reengineered processes to meet the changing needs of I&FS Insurance Programs and Services. Evaluates Benefit Workstation Automated
Proposal Management and NRECA Employee Benefit web site, to ensure accurate and timely information relative to NRECA benefit programs.
Essential Duties and Responsibilities:
- Facilitates inter-system flow of enrollment
and plan information relative to the annual renewal process for all group benefit (medical, prescription, vision, dental, life, disability) plans. Identifies plans due for renewal. Monitors website proposals to ensure plans are accurately renewed. Provides
status reports to management throughout the renewal process. Creates and manages the development of ongoing “issues” list and facilitates the tracking and resolution of co-op and internal plan related issues. Manages Plan Implementation
team’s annual renewal calendar.
- Manages the process to facilitate weekly and ad hoc proposal file loads to Benefit Workstation (BW). This includes ongoing analysis of the process to ensure that changing business and technical needs (new plan
designs and programs, system modifications, new interfaces) are addressed. Changes typically occur in conjunction with the year-end renewal cycle, but may occur more frequently, as needed. Proactively identifies and resolves data problems prior to proposal
load. Verifies that BW has been accurately updated. Responsible for accurate creation of weekly and ad hoc UMR Change Control files, and for auditing UMR’s system data to ensure that new, changed, and cancelled plans are updated correctly by
- Represents the Plan Implementation team as a Subject Matter Expert for the implementation of group plans on internal administration systems. Uses extensive and in-depth knowledge of Benefit Plan Rating, Benefits Workstation, and UMR to provide
guidance and recommendations for correct plan administration to internal and external resources. Develops and maintains Plan Implementation’s group plan procedures.
- Provides design guidance for ID card layout changes and performs testing to
ensure changes have been implemented according to specifications.Verifies sample of annual ID cards and creates manual, temporary cards upon request. Leads NRECA effort to work with UMR to develop new ID card designs and process flows and provide
transition support to the Member Contact Center as needed.
- Responsible for ensuring the accurate operation of the Automated Proposal Management system for medical, prescription, vision, dental, life, and disability proposals (over 10,000 proposals
annually). Determines appropriate voiding or rescinding of proposals. Updates and quality reviews new/replaced plan IDs to ensure proposals load successfully to BW. Based on proposal, identify appropriate type of recalculation and ensure participants and
invoices are updated correctly. Identifies and recommends improvements to Benefit Plan Rating and Automated Proposal Management (through IT and the I&FS System Implementation team).
- Gathers statistical data, assimilates results and presents
findings to management in the form of tabular and graphical reports and lists. Utilizes NRECA’s data warehouse and other data sources for reporting and analysis purposes - supporting I&FS Insurance Programs and Services. Incumbent must analyze
reporting needs and ascertain the approach to collecting needed data. Generates and sends various routine reports on a daily or weekly basis and well as providing statistical reports on a periodic basis. Supports I&FS staff by providing ad hoc reports
as requested (can range from several requests per week to bimonthly) based on annual business changes, such as monitoring HDHP plan limits, identifying co-op level new business and cancellations, and monitoring of Rx plan eliminations. Identifies
opportunities and writes requirements for Reporting Services reports that will increase team productivity
- Processes splits, mergers and new subgroups. Verifies individual records are updated appropriately within the established timeframe. Ensures
correct adjustments and/or billing is reflected on invoices. Conducts business improvement and business process analysis with respect to Plan Administration and, as appropriate, suggests ways to improve business processes and workflows to meet business
needs. Working with other business areas, ensures that process redesign provides greater efficiencies and a higher level of service to the membership.
- Leads efforts to identify and develop detailed business requirements in collaboration with IT,
I&FS System Implementation, external vendors, and various I&FS departments to ensure that business needs are met through technology solutions. Assesses the impact of BW and NEB web site technology changes to the work unit. Conducts system testing.
Develops test plans and test cases that validate business needs and expectations. Participates in user acceptance testing to validate that test results meet business requirements.
- Responsible for the proper security and disposal of any confidential
information that he or she may possess in the course of performing this position’s job duties, in accordance with NRECA’s Personnel & Administrative Policy and HIPAA Privacy and Security Policies & Procedures Manuals.
Direct Reports to this Position:
Formal Education Required:
Bachelor’s degree in Business Administration or a related field or an equivalent combination of education, training, and
Experience and Certifications Required:
5+ years experience working analytically in a systems environment. Experience and working knowledge of workflow and process flow documentation and analysis.
Experience ensuring data quality in large transactional systems and general experience in employee benefits industry.
FLSA Status: Exempt
Knowledge, Skills and Abilities Required (as demonstrated by prior work
- Ability to perform and work on multiple tasks while being flexible and able to cope with changing conditions/policies/procedures in a fast-paced and sometimes intense working environment, while staying productive and maintaining a
high level of accuracy.
- Ability to define and document processes and procedures
- Ability to define issues, establish facts and draw valid conclusions and apply to work environment.
- Ability to define user requirements and perform user
- Ability at training colleagues on business processes and systems.
- Ability to work independently and within a project team structure.
- Ability to organize and facilitate meetings to achieve desired
- Ability to communicate, both verbally and in writing, with a diverse membership, employees and/or vendors in a clear and precise manner.
- Ability to use Microsoft Office tools (Excel, Word, Outlook, Power Point) in the day-to-day
essential duties of the job.
- Ability to operate various office equipment such as personal computer, copier, printer, fax machine or other job-related equipment.
- Ability to provide service excellence by building relationships, being
resourceful, responsive and respectful.
Essential Physical Requirements:
- The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing;
viewing a computer terminal and extensive reading.
- Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls
requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work.
Disclaimer Statement: The preceding job description has been written to reflect management’s
assignment of essential functions. It does not prescribe or restrict the tasks that may be assigned.
The preceding job description has been written to reflect management’s assignment of essential
functions. It does not prescribe or restrict the tasks that may be assigned. All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin,
disability, veteran status, or other legally protected status.
NRECA is committed to working with and providing reasonable accommodation to individuals with physical and mental disabilities. If you need special assistance or an accommodation
while seeking employment, please e-mail email@example.com or call: 703-907-5992 - NRECA Arlington Human Resources. Please call 402-483-9275 - NRECA Lincoln Human Resources, for Lincoln, NE employment opportunities. We will make a determination on
your request for reasonable accommodation on a case-by-case basis.
EEO is the Law. The law requires NRECA to post a notice describing the Federal laws prohibiting job discrimination. For information regarding your legal rights and protections, please
click on the following link: EEO is the Law and EEO is the Law Supplement.
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