Director, Benefits & Administration (5103)

Job Posting

Director, Benefits & Administration
Organization:  Saskatchewan Blue Cross
Province:  Saskatchewan
Location:  Saskatoon
 
 
Description:

Posting ID: S1952

Position: Permanent Full Time           

Saskatchewan Blue Cross®, one of Saskatchewan’s Top Employers, is currently recruiting for a Director, Benefits & Administration in our Saskatoon office.

JOB FUNCTION

As a key member of the Saskatchewan Blue Cross (SBC) Senior Leadership Team, the Director of Benefits & Administration will report directly to the Snr Vice President of Operations. This position will provide leadership, mentorship and coaching and will work closely with the Health and Dental Claims and Group Administration operational leadership teams in setting and delivering on objectives and strategy.

                           

DUTIES & RESPONSIBILITIES

  • Develop and oversee the execution of the Strategic Plan and Vision for the areas of responsibility, participate in the development of the Corporate Strategic Plan and ensure alignment of departmental goals to corporate objectives 
  • Ensure departments under direct responsibility are optimally structured in order to enhance service offerings and service delivery
  • Set and monitor all Service Level Objectives, related projects as well as the day to day operational service delivery components within areas of responsibility
  • Lead, manage or participate in organizational projects and initiatives impacting areas of responsibility
  • Provide strategic advice, prepare and present reports, and recommend direction to the Senior Leadership team and/or other committees on industry service capabilities and offerings to ensure focus on continual customer service improvement and program optimization on benefit management issues
  • Work closely with departmental leaders of Health & Dental Claims and Group Administration to:
    • Develop the strategy for Claims Benefit Management and payment including cost containment, drug benefit management, Provider Relations and fraud prevention
    • Ensure insurance contracts and provider agreements remain aligned with and reflect claims benefits strategies and best practices, mitigate claims risks and comply with insurance legislation and regulations
    • Ensure effective and efficient processes with respect to plan member and plan administration activities such as group set up, enrollment, contract management, Member ID cards and billing
    • Evaluate service offerings to members, providers and administrators to ensure alignment with industry trends and competitor offerings
    • Oversee the development and execution of Fraud Investigation objectives, strategies, initiatives and techniques that support continuous improvement of SBC’s fraud prevention
    • Ensure the efficient, timely, and effective set up of Employer Groups to align with the client and advisor expectations
    • Ensure departments are utilizing technology to optimum capabilities to provide effective service delivery
    • Prepare and manage the departmental budgets; authorize, forecast, monitor and control expenditures
  • Act as a representative on related Canadian Association of Blue Cross Plans (CABCP) committees and other related Industry committees and act as a spokesperson with members, administrators, providers, clients, industry associations and other significant stakeholder groups
  • Monitor and keep abreast of industry, competitor, and CABCP trends in Benefits and Administration to ensure the organization remains competitive
  • Provide strong leadership, coaching and mentoring to the team
  • Provide input and direction on the identification, evaluation, management, and communication of key operational risks and the adequacy of internal controls
  • Liaise with health-related government and public agencies in matters of policy and health care developments that relate to benefits and administration
  • Partner with Directors and other stakeholders across the organization to ensure effective cross-departmental planning, communication and implementation of plans in achievement of SBC’s overall strategic plan 
  • Advocate, drive and manage change, ensure effective and timely communication to all impacted stakeholders both internal and external to the organization
  • Manage and develop direct reports, monitor performance objectives and outcomes and foster teamwork
  • Oversee and provide input to the human resources functions in the area including resource and succession planning, performance management, recognition, development, and recruitment
  • Other related tasks and duties as assigned
Requirements:

QUALIFICATIONS & SKILLS

  • Completion of a Bachelor’s Degree in a related field and 7-10 years of related experience preferably in the health sector or group insurance industry with progressive management experience.  An equivalent combination of training and experience may be considered.
  • Experience in benefits management, Group plan administration, provider relations, claims adjudication, and/or claims administration would be considered assets
  • Strong knowledge and interest in current and emerging insurance practices and standards
  • Effective communicator, mentor and coach, with experience leading teams with varying skills and knowledge
  • Proven ability to build effective relationships, both with internal and external stakeholders
  • Strong business acumen, critical thinking and proven analytical and decision-making skills to deal with complex and varying business issues
  • Project management, relationship management, and negotiation skills with ability to influence key stakeholders
  • Ability to manage change, think strategically, problem solve and create innovative solutions
  • High technical aptitude with the ability to understand system and process linkages as it relates to process and service delivery
  • Strong computer skills, with demonstrated proficiency in MS Word, Excel, Power Point with the ability to easily learn new programs
  • Must have a high level of integrity and accountability while demonstrating flexibility and initiative
  • Excellent interpersonal, verbal, written and presentation skills, with particular proficiency in preparing strategic plans and written reports
  • Proven capacity to work under pressure
  • Proven commitment to service excellence
  • The successful candidate may be required to undergo a background check
  • Must be legally entitled to work in Canada on an unrestricted basis