GENERAL FUNCTION:

The AVP/Senior Director – Ops and Admin is responsible for leading certain “Be The Member” client facing areas, which include Client Implementation and Operations, Plan Setup, ID Cards, and Operations Services and Membership  Major Responsibilities for “Be The Member” functions will include: 1) formulating strategy/vision for all defined areas of responsibilities; 2) driving process improvements while maintaining overall cost efficiency/effectiveness 3) develop business justification for strategic initiatives including financial/business analysis 4) supporting our 3 year system strategy/overhaul (i.e. claims system and web). The AVP/Senior Director is also responsible for managing growth and development of the “Be The Member” infrastructure and supporting all EyeMed’s “Grow Lives” charter.

MAJOR DUTIES AND RESPONSIBILITIES:

Implementation & Operations

§         Leadership of the overall Group implementation Process with respect to the constituents we serve:  client, member, and providers. This will include workflow management, resource planning, plan setup, internal controls, compliance and effectiveness of supporting client/member applications.

§         Define our Client Standards of Administration and ensure compliance thereto.

§         Ensure proper administration of client contracts and deliver service excellence for all constituents.

§         Drives the service vision for the Implementation/Operations areas by ensuring that customer issues are resolved promptly and processes/systems are design to deliver customer service excellence.

• Participates in RFP analysis and proposal process to ensure operational effectiveness of proposed administration platform.

§         Participates in client facing meetings to ensure understanding of client administrative requirements and procedures.

§         Drive client/member satisfaction through efficient and effective administration.

§         Lead client-facing initiatives as needed by the business/our constituents.

Membership

§         Establish and maintain customer service vision for Membership.

§         Ensure control processes are in place to effectively monitor departmental activities and ensure SLA’s measures are achieved.  

• Understand and document client administrative needs, including benefit structure, file transmission, performance guarantees, etc
• Ensure client understanding of EyeMed’s systems capabilities and limitations.
• Ensure client interfaces are fully tested prior to implementation.

§         Maintains the integrity of membership data in the EyeMed eligibility system by leading the creation and installation of policy/procedures to deliver on quality and process measurements.

• Leads the client issue resolution process by making administration recommendations and driving effective and timely resolutions.
• Participates in client meetings to ensure understanding of membership data requirements and procedures
• Ensure databases have appropriate control processes to ensure ongoing data integrity, SOX internal controls and Underwriter compliance.
• Participate and/or lead cross-functional teams with regards to Plan Implementation, EDI Initiatives, Card Production, Process Improvements, etc.

Staff Management and Leadership

• Effectively supervises and monitors Functional Teams and Associates: 

1.       Establishes and maintains managerial practices that drives a high level of motivation with group in accordance with company policies, procedures, and department standards. 

2.       Holds regular team meetings and one-on-one touch bases with direct reports.

3.       Coordinate communication to staff regarding new plans, system enhancements, and process changes. 

4.       Responsibility for annual performance reviews and career development plans for staff.

5.       Achieves ASAT scores equal to or in excess of the total EyeMed goal.

• Drives client satisfaction through efficient and effective administration:

1.       Drives communication between group implementation, account management and customer service to enhance department productivity and client service.

2.       Leads the client issue resolution process by making administration recommendations and driving effective and timely resolutions.

3.       Participates in client meetings to ensure understanding of client administrative requirements and procedures

4.       Establish and maintain customer service vision for Functional Departments.

5.       Support VP of Operations with client service initiatives.

• Support the Sales and Client Retention initiatives: 

1.       Leads the new client installation process for the EyeMed Operational area and ensure systems and process will support benefit execution and member service

2.       Participates in RFP analysis and proposal process to ensure operational effectiveness of proposed administration platform.

3.       Evaluate and facilitate approval of administrative exception requests with focus on ability to provide consistent/quality results and operational efficiency. Maintains effective and on-going communication with key customer interfaces that include EyeMed Account Managers, Operations, Information Systems, Client Representatives and EyeMed leadership team.

4.       Participates in customer interface projects and various key departmental projects that contribute to EyeMed business success.

• Leads the group implementation function in respect to overall client, member, provider and broker experience.

1.       Understand and document client administrative needs, including benefit structure, file transmission, performance guarantees, etc

2.       Ensure client understanding of EyeMed’s systems capabilities and limitations.

3.       Ensure data structure for ongoing EDI files will support the desired benefit execution.

4.       Document and distribute the various functional requirements.

5.       Ensure client interfaces are fully tested prior to implementation.

• Identify and recommend systems and process modifications necessary to effectively and efficiently support various applications including

1.       Maintains a detailed knowledge of the EyeMed GI Tracker/Metastrom, Group Portal, Card Process and AS400 Plan Set-Up applications and applies knowledge to improving the effectiveness and efficiency of department operations.

2.       Analyzes and evaluates procedures to ensure continuous improvement.

3.       Develops test procedures (Integration and UAT) to ensure all system modifications are fully tested prior to implementation.

COMMUNICATION WITH OTHERS

• INTERNAL - Frequent oral and written communication with internal associates and field management.  Ensure upward and downward communication to keep management and associates properly informed.
• EXTERNAL – Frequent oral and written communication with clients, brokers, software/system providers, and third party administrators.

KNOWLEDGE AND SKILLS:

• Demonstrated leadership of large operational/financial teams to drive vision/strategy and deliver results (short and long term) including associate satisfaction
• Strong financial/accounting technical skills including demonstrated experience with business process reengineering
• Strong Customer and Service focus with the ability to act as the customer/member ombudsperson within the organization.
• Experience in an administrative liaison role (internal and external customers)
• Ability to work well under pressure and multi-task
• Business process, system and diagnostic capabilities with an affinity for crafting creative solutions based on facts gained using an analytical approach and process.
• Ability to problem-solve, balancing service initiatives with fiscal goals and to develop cross-functional solutions.

EDUCATION:

Bachelor’s Degree or equivalent experience

MBA or CPA preferred

EXPERIENCE:

• 10-15 years experience in Finance/Accounting/Operations
• 7-10 years of supervisory experience in large operational/financial teams
• Systems development/integration experience with focus on large scale business process re-engineering
• Proven track record identifying and implementing Efficiency/Effectiveness initiatives
• Successful track record driving high levels of constituent satisfaction (external and internal customers)

EOE