TPA Implementation Executive

Posted 6 Hours Ago
Be an Early Applicant
Hiring Remotely in USA
Remote
171K-256K Annually
Senior level
Healthtech • Software
The Role
The TPA Implementation Executive is responsible for leading new client implementations, managing expectations, and ensuring client satisfaction in SKYGEN’s Third Party Administration business. Key tasks include developing best practices, overseeing system configurations, and fostering continuous improvement. The role collaborates with SaaS implementation teams and maintains executive relationships for successful implementations.
Summary Generated by Built In

What are important things that YOU need to know about this role?

  • This is a newly created position that can be based remotely in the US!
  • Seeking an experienced leader who can build out the team, collaborate with the SaaS implementation team and quickly learn the complexities of our business. 
  • Essential to have a hands-on leader who can work with clients, manage expectations and bring best practices to help establish this function at SKYGEN.

What will YOU be doing for us? The TPA Implementation Executive is responsible for successful new client implementations for SKYGEN’s Third Party Administration business as measured by cost, time, client satisfaction and quality. The role is also responsible for establishing a consistent approach and processes for implementations.

What will YOU be working on?

  • Oversee and provide leadership on new client implementations to include but not limited to the following:
    • First time SKYGEN TPA client
    • Current client that implements a new market segment (e.g. a Medicaid client who implements Medicare or Group/Individual business for the first time)
    • A dental TPA client who implements vision business or a vision client who implements dental business
    • Client moving from SaaS to TPA
  • Establish, maintain, and drive continuous improvement related to consistent methodologies for successful end to end implementations including identifying business requirements, mapping requirements to TPA workflows, efficient system configurations, reports, and testing.
    • Overseeing the translation of client business requirements into effective operational workflows, Electronic Data Interchange processes, integrations with the client’s internal and/or third party systems, and other system functional requirements.
    • Mapping client reporting requirement to SKYGEN standard reports.
    • Monitoring progress of each implementation and proactively communicating with clients as needed surrounding issues of potential significance.
    • Oversee the development of system configuration testing processes. Monitor testing to ensure quality outcomes.
    • Adopt and leverage core system functionality and solutions.
  • Collaborate and establish company-wide best practices in conjunction with SaaS implementation leadership.
  • Establish and maintain executive and project level relationships for TPA implementations.
  • Monitor cost of project and take actions to ensure financial commitments are met.
  • Ensure adherence to contract change request processes.
  • Provide feedback and participate as required in internal discussions surrounding system software upgrades.
  • Work effectively and collaboratively with peers and other internal resources in diagnosing and resolving issues.
  • Update COO-TPA Business and Chief Strategic Initiatives Officer (CSIO) on any significant issues in relation to implementations.
  • Maintain knowledge of industry best practices and implement appropriate solutions to maintain organizational competitiveness.
  • Foster an environment of continuous improvement though process and systematic efficiencies.
  • Work in conjunction with Human Resources to evaluate viable candidates under consideration for hire by identifying necessary skills and core competencies for various roles, developing relevant interview questions to assess candidate knowledge, skill, and position fit with future growth and business objectives, and utilizing appropriate selection techniques.
  • Develop, and motivate staff. Initiate and communicate a variety of personnel actions including employment, termination, performance reviews, salary reviews, disciplinary actions, and development plans. Provide regular and behaviorally specific feedback to increase performance levels.
  • Develop and implement appropriate training methods to ensure staff is provided with the appropriate tools to meet client requirements and objectives.

What qualifications do YOU need to have to be GOOD candidate?

  • Bachelor’s degree in Information Technology, Computer Science, Healthcare, Program Management or related field or equivalent years of experience.
  • 7+ years of experience in business process outsourcing implementations software and/or system implementations.
  • 6+ years of people management experience.
  • Demonstrated success leading multiple concurrent client implementations and multi-year implementation programs.
  • Strong client relationship management and negotiating skills.
  • Knowledge of commonly used project management tools.
  • Strong problem solving skills and conflict management skills.
  • Ability to manage multiple priorities and remain organized with multiple interruptions.
  • Demonstrated skill in utilizing data to drive decisions and behaviors.

What qualifications do YOU need to have to be GREAT candidate?

  • Experience with dental or vision BPO implementations is preferred.
  • PMP Certification.
  • Previous experience in a managed care environment.

The salary range and midpoint is listed below for your reference. Please keep in mind that your education and experience along with your knowledge, skills and abilities are taken into consideration when determining placement within the range.

Compensation Range:

$170,874.00 - $256,312.00

Compensation Midpoint:

$213,593.00

Top Skills

Java
Python
SQL
The Company
HQ: Menomonee Falls, Wisconsin
470 Employees
On-site Workplace
Year Founded: 1993

What We Do

SKYGEN powers dental and vision connectivity solutions that inspire clients to move confidently into the future by employing technology that creates unparalleled efficiencies, streamlines marketplace interactions and drives better healthcare access, value and satisfaction. We help dental, vision and other specialty benefit payers in both commercial and government markets become the most efficient and effective healthcare organizations in the country through intelligent software as a service (SaaS) automation, technology-enabled services, marketplace connectivity and risk management solutions. SKYGEN powers the nation’s largest healthcare insurers with clients operating in more than 100 markets, serving more than 35 million member lives on its technology platform, and 10 million member lives through its technology-enabled services. For more information, www.SKYGENUSA.com.

We're looking for innovative individuals to join our team! Learn more about SKYGEN, our culture, and how we can power your career today. We offer exceptional professional growth opportunities; a healthy work-life balance; and competitive salary and benefits. Positions are posted at http://skygenusa.com/Careers.htm.

Similar Jobs

Upstart Logo Upstart

Senior Operations Manager, Auto Collections

Artificial Intelligence • Fintech • Machine Learning • Social Impact • Software
Easy Apply
Remote
2 Locations
1500 Employees
127K-176K Annually
Remote
USA
65 Employees

Cash App Logo Cash App

Issuing and Deposits Operations Lead

Blockchain • Fintech • Mobile • Payments • Software • Financial Services
Remote
Hybrid
8 Locations
3500 Employees
189K-284K Annually

CNA Logo CNA

AVP, Risk Control (Commercial Auto)

Cloud • Insurance • Professional Services • Analytics • Cybersecurity
Remote
United States
7000 Employees

Similar Companies Hiring

Jobba Trade Technologies, Inc. Thumbnail
Software • Professional Services • Productivity • Information Technology • Cloud
Chicago, IL
45 Employees
RunPod Thumbnail
Software • Infrastructure as a Service (IaaS) • Cloud • Artificial Intelligence
Charlotte, North Carolina
53 Employees
Hedra Thumbnail
Software • News + Entertainment • Marketing Tech • Generative AI • Enterprise Web • Digital Media • Consumer Web
San Francisco, CA
14 Employees

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account