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Reference Number: 2009-61
Job Description: Price and monitor all rates and provider reimbursement mechanisms for all products and networks across all regions. Select and develop all reporting employees by providing or facilitating appropriate training, coaching and evaluating consistent with the corporate objectives. Manage information technology and data user needs particularly through decision support tools and analysis. Set and manage the overall target loss ratio and refund liability by plan, product and network for all regions. Ensure consistency with market trends, legal and regulatory requirements for all products by reviewing, establishing and monitoring underwriting guidelines for all regions. Meet legal requirements by filing all proper filings with the Division of Insurance including benefit and rating filings. Testify on behalf of the organization at all public hearings. Present and sell large and special account pricing for all regions. Set the overall strategy and direction of the organization through leadership of initiatives, projects and participation in the leadership group.
Experience Level: Unspecified
Requirements: 7 years experience in similar or related capacity. 2 years managerial experience. Experience in managed care, multi-product financial/underwriting environment. Strong written and oral communications skills. Strong negotiation and conflict management skills. Strong technical (statistical analysis, etc) skills. Highly organized, ability to track multiple projects and processes simultaneously.
PHYSICAL AND ENVIRONMENTAL CONDITIONS Should be able to function in a traditional office setting. Should be able to operate personal and other forms of computer equipment in a speedy an efficient manner. Should be able to prepare and present the results of analysis (materials, reports, etc) to variety of audiences both inside the company as well as outside.
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