Pay Range:
$58,700.00 - $79,300.00Please email [email protected] if you are a candidate seeking a reasonable accommodation for the application and/or interview process.
At BCBSRI, our greatest resource is our people.
We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do—not just for our members, but for our employees as well.
We recognize that to do your best work, you have to be your best self.
It’s why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees.
Our culture is one of belonging.
We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you’re at in the organization, you’re an integral part of our team and your input, thoughts, and ideas are valued.
Join others who value a workplace for all.
We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders.
We’re dedicated to serving Rhode Islanders.
Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state—building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer.
Why this job matters:
Prepare subscriber agreements and benefit booklets for distribution. Ensure documentation adheres to all state laws and regulations, accurately reflects benefits purchased by employer groups, and is prepared within established timeframes.
What you will do:
- Develop and modify member benefit documents that clearly represent the terms and conditions of the plans and benefits purchased by our groups.
- Collaborate with internal areas to ensure templates are annually updated, operational and adhere to internal and regulatory standards.
- Produce and provide ongoing inventory reporting that assists in monitoring the volume and timeliness of deliverables.
- Monitor and respond to inquiries and requests from internal business partners such as Sales, Operations, Grievance and Appeals, Utilization Mgt. in the established timeframes.
- Research historical account data and retrieve/produce supporting benefit/contract documentation for litigation purposes.
- Ensure subscriber agreement database provides accurate subscriber agreements to internal and external customers. Identify and triage database issues. Assist with the testing of database updates prior to implementation.
- Serve as administrator of the subscriber agreement database; ensure documentation is stored in accordance with BCBSRI policies and procedures. Analyze the weekly outlier report and develop any benefit documents added as a variation in the large or small group market.
- Provide detailed benefit documents to the custom implementation team and participate in custom group implementation meetings on behalf of department, as necessary
- Participate in department initiatives and projects, including the identification of opportunities to automate/streamline processes related to the production of member documents.
- Perform other duties as assigned.
What you need to succeed:
- Two or more years of relevant professional experience supporting legal, regulatory, operational, or administrative functions.
- High School Diploma, Associate’s or Bachelor’s degree, or an equivalent combination of education and experience
- Detail oriented
- Demonstrated written and verbal communications skills
- Ability to exercise sound judgment
- Ability to establish and maintain strong working relationships with various stakeholders
- Ability to organize work efficiently to meet established time and quality standards
- Good organization skills
- Good time management skills
- Proficiency with Microsoft Suite of products; i.e., Word, Excel, PPT, etc
The extras:
- Familiarity with BCBSRI product portfolio
- Experience with health insurance benefits, regulations, contracting and policy issue requirements
- Experience with Salesforce and SharePoint databases
Location:
BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role:
- In-office: onsite 5 days per week
- Hybrid: onsite 2-4 days per week
- Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia
Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today’s healthcare industry. BCBSRI is an equal opportunity employer.
The law requires an employer to post notices describing the Federal laws. Please visit www.eeoc.gov/know-your-rights-workplace-discrimination-illegal to view the "Know Your Rights" poster.
Skills Required
- Three to five years experience in benefit plan operations or sales operations activities
- High School Diploma, Associate's or Bachelor's degree, or equivalent combination of education and experience
- Detail oriented
- Demonstrated written and verbal communications skills
- Ability to exercise sound judgment
- Ability to establish and maintain strong working relationships with various stakeholders
- Ability to organize work efficiently to meet established time and quality standards
- Good organization skills
- Good time management skills
- Proficiency with Microsoft Suite (Word, Excel, PowerPoint)
- Familiarity with BCBSRI product portfolio
- Experience with health insurance benefits, regulations, contracting and policy issue requirements
- Experience with Salesforce and SharePoint databases
What We Do
Blue Cross & Blue Shield of Rhode Island (bcbsri.com) is a non-profit, community-focused health plan founded in 1939 to help Rhode Islanders finance their healthcare needs. Today, that’s still a big part of what we’re all about. We are committed to improving the health and peace of mind of our members by facilitating their access to affordable, high-quality healthcare. Our goal is to improve the quality of life of our customers and of the people of Rhode Island by improving their health for generations to come. We are an independent licensee of the Blue Cross and Blue Shield Association.







