Wellfleet, a Berkshire Hathaway company, delivers customer-centric accident and health insurance, with quality service and uncompromising ethics. Wellfleet works to protect people against risk throughout every stage of life – from grade school to college to the workplace.

Founded in 1993 as Consolidated Health Plans (CHP), Wellfleet, headquartered in Springfield, Mass., is one of the nation’s leading providers of health and accident insurance products to the higher education market.

Wellfleet a Berkshire Hathaway Company, seeks an experienced Operations Manager with demonstrated expertise with a variety of insurance products.

This position is responsible for ensuring proper operational controls are in place and monitored by Wellfleet and its Third-Party Administrators (TPAs). The Operations Manager will demonstrate expertise in a variety of health, accident, and voluntary insurance products to ensure industry best practices and Wellfleet-specific practices are consistently utilized. This position will provide leadership and management necessary to engage Wellfleet operational subject matter experts in the ongoing oversight of our TPAs in policy administration, enrollment, billing & collections, claims, customer service, compliance, data and reporting. This position will lead the effort to research, analyze and resolve operational concerns. This position will assess key performance metrics and quality measures to ensure Wellfleet service levels are consistently met and drive continuous improvement by implementing enhanced workflows/guidelines and technologies to improve measures, optimize use of resources and reduce overall operational costs. The Operations Manager will stay current with insurance industry best practices and compliance with state and federal regulations.

In this role, you will…

• Be responsible for day-to-day oversight of Wellfleet’s key TPA partners to foster a successful, results-oriented, accountable environment that provides efficient services and products that meet the needs of our customers
• Collaborate with business owners to ensure adherence to due diligence requirements and appropriate Service Level Agreements are tracked as a part of the ongoing operational monitoring process
• Contribute to the team’s success by building positive relationships through collaboration with stakeholders
• Analyze reports to ensure TPAs meet key performance indicators and benchmarks. Communicate results effectively with internal team members and senior management
• Act as a point of contact between SMEs and TPAs to ensure new or changing threats and vulnerabilities are addressed and resolved
• Maintain understanding of the lifecycle of an insurance transaction and the workflows/systems and processes performed
• Collaborate with various Wellfleet SMEs to develop and implement oversight plans and successful tracking of operational deliverables based on the products and services outlined in the administration agreements (SOWs)
• Act decisively and timely in challenging situations with a sense of urgency
• Proactively engage team members across the organization to address operational issues
• Provide clear and comprehensive rationale for decisions/actions to team members, project owners and leadership
• Assist in the creation of guidelines and ensure appropriate adherence by TPAs
• Demonstrates ability to perform in a professional manner with a positive attitude
• Provide leadership and oversight of issue resolutions to ensure deadlines are met
• Works with the Audit Team to perform TPA audits (onsite and remotely)
• Identify root cause of issues to create action plans to ensure goals are achieved
• Ensure all escalated complaints or concerns are acted upon in a timely manner
• Regularly communicate with business owners and management on the health of the TPA relationship
• Performs other duties as assigned
  
  
  

We are looking for candidates with…

• Bachelor’s degree in healthcare administration, business management, or a related field with 5+ years’ of experience in an operational capacity in the insurance industry, or equivalent combination of education and experience
• Solid understanding of health insurance and/or voluntary benefits markets and the back-office administrative processes supporting the life cycle of an insurance contract
• Ability to interpret state and federal regulations and requirements and assess application to operations
• Possess critical thinking skills with proven ability to identify and analyze complex problems and review related information to develop and evaluate options to implement solutions
• Demonstrated ability to efficiently manage multiple assignments and prioritize tasks in a fast-paced environment to meet deadlines
• Proven success in implementing performance, service, and productivity improvement processes
• Strong written, verbal and presentation skills
• Excellent project management skills
• Strong interpersonal and communication skills with the ability to work effectively with both internal team members and external stakeholders
• Flexible with the ability to collaborate effectively with peers and business partners
• Ability to adapt and pivot and when presented with new information or circumstances
• Self-motivated with the ability to work independently, with very little supervisory direction
• Proficiency in MS Office Suite, specifically Outlook, Excel, PowerPoint and Word
  
  
  

Why Wellfleet?

Here at Wellfleet, we foster a culture of growth that enables engaged and high-performing professionals to be empowered to deliver our mission and vision.

Our employees are a team devoted to providing customer service that exceeds expectations of our members and clients. Successful team members continually look for ways to improve product delivery and value.

Wellfleet offers a competitive compensation package and comprehensive benefits package including life, health and dental, vision, 401K retirement plan, short- and long-term disability coverage, flexible/dependent care spending account, tuition reimbursement, and business casual dress.

Are you interested in exploring a career at Wellfleet? Explore our open positions.

General:

Wellfleet is part of the MedPro Group family. As such, all Wellfleet team members are employees of MedPro Group Inc. We are an Equal Opportunity Employer.