HealthPartners is hiring an Electronic Enrollment Systems Specialist. This position is responsible for the implementation, maintenance and support of HealthPartners electronic enrollment process for employer groups. Responsible for strengthening and supporting Membership Accounting staff knowledge of electronic enrollment and related business processes. Assist in increasing the efficiency and accuracy of the electronic enrollment system. Responsible for the evaluation of current electronic processes and programs as well as participating in the development, testing, and implementation of system programs and enhancements for employer groups. Acts as a liaison between electronic enrollment employer groups, IT, HealthPartners departments and other external customer clients.
ACCOUNTABILITIES:
Implementation of Electronic Employer Groups
- Leads implementation project activity for employer groups electing to participate in HealthPartners electronic enrollment processes.
- Gathers, analyzes and documents employer group details as they relate to HealthPartners internal business requirements and electronic enrollment implementation.
- Develops and communicates electronic enrollment functional requirements, implementation process and data specifications to HealthPartners Sales account managers, employer group representatives and/or TPAs and brokers acting on the employer group's behalf.
- Works with Sales, Membership Accounting, IT and employer groups to develop and achieve implementation project objectives, deliverable schedules, test and acceptance criteria, training and education.
- Completes comprehensive testing requirements to ensure integrity of data submitted to our membership system via the electronic enrollment processes.
- Maintains current knowledge of various electronic data file formats and analysis tools to ensure correct interpretation and mapping of data elements as submitted electronically. (i.e. Multi Edit, Archive Files)
Support of Electronic Enrollment Employer Groups
- Assists employer groups, Sales, Membership Accounting and other HealthPartners departments as the primary technical resource regarding questions/problems related to the use of electronic enrollment system and process.
- Independently investigates, analyzes and documents problems/issues related to the electronic enrollment system, processes, employer group data or files. Assists in or directs the development and coordination of problem resolutions with employer group, Sales, Membership Accounting and IT as necessary and identifies any related training requirements for staff.
- Provides updated information regarding status and resolution of system problems/issues to Manager of Electronic Enrollment and Membership Accounting supervisor/manager.
- Coordinates and manages data or file format changes with the appropriate resources.
- Participates in the annual open enrollment activities for electronic enrollment employer groups including the subsequent Continuous Quality Improvement process (CQI).
- Performs, as necessary, routine maintenance on Electronic Enrollment and related membership system dictionaries or databases that control enrollment restrictions or defaults for clinics, products, student validation rules etc.
SRF/System Enhancements
- Participates with the Membership Accounting and IT teams in the development, maintenance or adaptation of the electronic enrollment program and process design.
- Participates in risk analysis relative electronic enrollment systems and processes.
- Develops recommendations and proposals concerning system modifications and enhancements, business process modifications and enhancements that will serve to increase efficiency in the process and in the use of the systems available.
- Creates and performs comprehensive system and acceptance test plans for routine changes and major modifications or development in the membership/electronic enrollments systems.
- Assists in developing membership system dictionaries to support new electronic processes.
- Provides technical information to Membership Accounting staff trainers in the development and preparation of user documentation, processing and operations procedures.
Other
- Position requires managing priorities and accepting responsibility for continued professional development.
- Successfully completing other special projects or duties related to the position as directed by the Electronic Enrollment Manager.
REQUIRED QUALIFICATIONS:
- Demonstrated ability to actively participate on and contribute to a high performance team.
- Two or four year college degree (or technical college certificate) with focus in computer science or business management or two years experience in a systems development or analysis position.
- Demonstrated skill in analyzing and interpreting data and action plan development.
- Advanced problem-solving skills and ability to work independently.
- Demonstrated planning, organization, and time management skills.
- Familiarity with continuous improvement concepts and Quality methodologies.
- High degree of initiative.
- Working knowledge of computer programming and data processing capabilities.
- Ability to meet deadlines while dealing with ambiguity and changing priorities.
- Excellent written and verbal communications skills.
- Ability to make logical decisions.
- Ability to give attention to detail.
PREFERRED QUALIFICATIONS:
- Experience with the HealthPartners' membership system and functional areas.
- Experience with systems/application analysis and testing.
- Familiarity with HealthPartners products or general HMO product knowledge.
- Previous experience with Windows NT, Microsoft Office (to include Word, Excel, PowerPoint, and Access).
DECISION-MAKING:
- The Electronic Enrollment Systems Manager establishes priorities on system or process development, changes and enhancements with input from the position.
- The Electronic Enrollment Systems Manager must approve all system changes prior to moving such changes to production.
At HealthPartners we believe in the power of good - good deeds and good people working together. As part of our team, you'll find an inclusive environment that encourages new ways of thinking, celebrates differences, and recognizes hard work.
We're a nonprofit, integrated health care organization, providing health insurance in six states and high-quality care at more than 90 locations, including hospitals and clinics in Minnesota and Wisconsin. We bring together research and education through HealthPartners Institute, training medical professionals across the region and conducting innovative research that improve lives around the world.
At HealthPartners, everyone is welcome, included and valued. We're working together to increase diversity and inclusion in our workplace, advance health equity in care and coverage, and partner with the community as advocates for change.
Benefits Designed to Support Your Total Health
As a HealthPartners colleague, we're committed to nurturing your diverse talents, valuing your dedication, and supporting your work-life balance. We offer a comprehensive range of benefits to support every aspect of your life, including health, time off, retirement planning, and continuous learning opportunities. Our goal is to help you thrive physically, mentally, emotionally, and financially, so you can continue delivering exceptional care.
Join us in our mission to improve the health and well-being of our patients, members, and communities.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant because of race, color, sex, age, national origin, religion, sexual orientation, gender identify, status as a veteran and basis of disability or any other federal, state or local protected class.