Plan Design Implementor
- - Plan Design
- Minneapolis , MN, USA
- Full Time
Bind is a health technology and services company founded in 2016 and headquartered in Minneapolis, MN with a San Francisco satellite. Bind is health insurance for the way we live now. Unlike traditional health insurance that charges you for services you may never need or want, Bind is on demand: pay for what you need, not what you don't, and adjust your coverage when those needs change. Health coverage that's flexible, clear, and intuitive.
We are creative, collaborative, and a little bit fiery. The Bind team is comprised of like-minded individuals passionate about healthcare, and our cause is the collective act of rewiring it. We embrace new ideas. We're more wheel than cog. More spark than smoke. And we are playful and venturesome in our daily mission to render real and refreshing solutions to health insurance that works better for us all.
Plan Design Implementor
Bind is actively seeking a highly skilled, motivated and experienced Plan Design Implementor to join our growing team. In this position, you will play a key role in establishing and enabling the Bind benefit plans. Partner with Sales, Account Partners, Clinical and Operations subject matter experts to design the benefits within the plan design that enables use of Bind's innovative offerings. The Plan Design Implementor will be responsible for innovation, development and implementation of the Bind Plan Designs and Benefits.
- Responsible for development, integration, and implementation of plan and program arrangements
- Collaborate with Legal and Account Partners to maintain and update the benefit documents, e.g., SBC and SPD, to ensure content represents the Bind and customer intent of the benefits and programs
- Lead the development of language within internal and external documents that articulate the intent of plan design and benefits, i.e., SBC and SPD
- Facilitate meetings with Account Partners, Clinical, Operations and others to achieve benefit design solutions that meet needs and expectations
- Participate in analysis, development, and implementation of Bind's benefit intent
- Participate in ongoing innovation and maintenance of plan design and benefits
- Work with Plan Design, Clinical, Network, Operations and Sales to analyze, design and implement new programs and benefit within new and existing plan designs
- Manage the maintenance and updates to benefit sets, e.g., durable medical equipment, complex drug administration, and mental health
- Ensure compliance with member benefit regulations across Bind plan designs (Mental Health Parity, etc.)
- Serve as a resource regarding plan design and benefit interpretation of standards. Collaborate with Plan Design and Coding Manager on use of codes and changes to coding standards as needed
- Assist in translation of consumer-friendly medical terms and concepts into search terms and documents
- Ensure adherence to state and federal compliance policies, reimbursement policies and contract requirements
- Perform additional duties as assigned
- Bachelor's degree or equivalent years of relevant work experience.
- 5+ years business/operations experience in a health plan environment and familiarity with commercial plan design
- 5+ years of medical benefit plan design and/or configuration
- Working knowledge of HCPCS, CPT, ICD10 CM and PCS, J codes and Rev codes
- Experience performing coverage review which requires interpretation of state and federal mandates, applicable benefit language, medical and reimbursement policies, coding requirements and consideration of relevant clinical information on claims
- Strong analytical skills
- Clear, concise, engaging and effective written and oral communication
- Willingness and ability to be both an individual contributor and a team player
- Ability to influence without direct control
- Proficient in Microsoft Word, Excel, PowerPoint, etc.
- Accurate and precise attention to detail
Bind is committed to providing equal employment opportunities. All qualified applicants and employees will be considered for employment and advancement without regard to race, color, religion, national origin, sex, disability, age, marital status, sexual orientation, veteran status, genetic information, or any other status protected by applicable law.