Company Statement

For the last 80 years, EmblemHealth has been taking care of New York’s heart and soul, its people. Today, health care is more complex than ever. That’s why we’re at the forefront of change. We work alongside our customers to offer access to high-quality, affordable care, help navigate the health care experience, and make good health achievable; because everyone deserves to be taken care of. We deliver on our mission every day by living our values with our colleagues, members, clients and partners. It begins with caring and respecting all those we work with. We believe a culture of diversity and inclusion is vital to serve our unique and diverse customers. We seek for continues improvement and innovation and believe being agile and nimble is our advantage. We bring a strong sense of partnership to every relationship – internally and externally. The EmblemHealth family of companies offers competitive health, welfare, and retirement benefits as well as incentive pay plans and more.

Director, Case Installation

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Director and Equivalent
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1906T Requisition #
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Plan, direct, and oversee the installation of all employer business for EmblemHealth’s commercial, group Medicare and ancillary product portfolio.  Responsible for add issue and client level policy/plan changes across all lines of business and across all market segments; ensure case installation projects are accomplished in a timely manner with high quality; and monitor and report key performance metrics. This is a highly visible and critical business role and the successful candidate should expect to succeed in a fast-paced and challenging work environment.

Responsibilities:
  • Provide strategic direction, leadership and oversight for all case installations and case changes across all lines of business and across all market segments at EmblemHealth. 
  • Lead a cross functional Case Installation team reporting to senior leadership providing regular updates and escalating issues in a timely manner; serve as case installation subject matter expert.
  • Identify and respond to new or unique case installation requirements including those related to strategic direction and to the implementation of Emblem Health’s Facets claim system. 
  • Design, develop, document and execute processes in advance of case effective dates. 
  • Continuously improve and refine case installation and case change methodology.
  • Define quality assurance processes and goals for successful case installations and changes. 
  • Collaborate with multiple EmblemHealth departments and client representatives to achieve quality goals including timely and error free installations.
  • Set training goals for staff responsible for case installation activities; ensure adequate training and process adoption. 
  • Ensure adequate staffing and service levels. 
  • Manage, mentor, and develop staff as needed; evaluate staff performance and ensure standards are met. 
  • Address staff improvement initiatives where necessary.
  • Maintain client satisfaction by identifying and implementing performance indicators, monitoring performance, addressing gaps in a timely manner. 
  • Assist sales, underwriting and other internal business partners to effectively manage our client’s expectations in accordance with the organization’s guidelines.
  • Create a case installation environment that promotes integration and collaboration across departments.
Qualifications:
  • Bachelor’s degree in Business, Healthcare, or related field required
  • Master’s degree preferred
  • Minimum of 10 years in healthcare/managed care industry with Program performance measurement, analytics, reporting and forecasting required
  • Program performance measurement, analytics, reporting and forecasting required
  • Presentation experience to leadership teams, clinicians, and employer groups is required
  • Can translate daily activity into the long-term impact on Group Insurance’s Critical Priorities required
  • Prior group insurance industry experience and technical expertise required
  • Ability to consult and collaborate cross-functionally with other departments to problem solve required
  • Demonstrated experience managing multiple priorities and balancing competing priorities required

EEOC Statement

We are committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law.

Sponsorship Statement

Depending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, EmblemHealth may provide work visa sponsorship for certain positions.

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