Company Overview:

Join Self Fund Health, an innovative startup reshaping the healthcare landscape for Wisconsin businesses. Our mission is to empower companies to take control of their healthcare expenses through self-funded health plans, Direct Primary Care (DPC), and free-market care solutions. We’re dedicated to providing high-quality, affordable healthcare options that align with our clients' financial goals while challenging the status quo of traditional fully insured plans.

As part of our close-knit, mission-driven team, you’ll play a key role in creating positive change in healthcare throughout the state and surrounding areas. Wisconsin is currently ranked among the top five most expensive states for healthcare; we are determined to change that.

Position Overview:

We are seeking a dynamic Account and Implementation Manager to serve as the primary point of contact ensuring a smooth, seamless experience focused on client satisfaction starting from the implementation of new/renewing clients and throughout their journey with Self Fund Health. This role will work closely with brokers, employers, internal teams, and vendor partners across Wisconsin and the Midwest. This role is responsible for developing and maintaining strong trusted relationships, overseeing plan performance, delivering proactive solutions to optimize savings and increase DPC and Preferred Provider utilizations, driving a seamless onboarding experience, manage renewal process including negotiating stop loss rates and implementing benefit plan designs aligned with the Self Fund Health model, ensuring compliance and SPD negotiations, and graciously handling escalations while ensuring client satisfaction and retention.

This role requires a professional who understands the healthcare landscape, understands what it takes to maintain client relationships and is passionate about revolutionizing healthcare for local businesses and their greatest assets – their employees and their families.

The ideal candidate will have experience and thrives working within the health insurance industry (at a health plan, broker agency, health care provider system, network, TPA, etc.) and is well-versed in managing relationships while maintaining and exceeding service level expectations within a fast-paced environment. Success in this role will be defined by the ability to maintain trusted relationships with clients, drive engagement and utilization strategies, exceed client experience expectations, and meet savings and retention goals while remaining eager to learn and grow.

Key Responsibilities:

• Client Relationship Management:

• Professionally serve as primary liaison building strong relationships between the health plan, employer groups, brokers and our vendor partners providing outstanding client service and resolution ensuring client satisfaction and goals are met.

• Implement successful strategies to reach savings, employee engagement, DPC and Preferred Provider utilization and retention goals.

• Educate clients on Self Fund Health’s model and best practices for success, cost-containment strategies, population health management, self-funding strategies, and resources for success.

• Conduct regular virtual or in-person meetings to review plan performance, address concerns and identify opportunities for plan enhancements and communicate strategies.

• Guide clients through complex health plan benefit discussions, including stop-loss claims and funding, contract negotiations, and savings opportunities.

• Address escalated member issues, stop-loss claim disputes, benefit plan and network/provider concerns in collaboration with TPAs and carrier vendor partners.

• Identify process improvement opportunities to enhance client satisfaction and operational efficiency.

• Plan Implementation & Renewal Management:

• Manage and lead the onboarding and implementation of new employer groups transitioning to Self Fund Health.

• Coordinate with TPA’s, brokers, employers and vendor partners to ensure seamless plan implementations, optimal client offerings and plan administration.

• Facilitate annual plan renewals, including benchmarking, stop loss negotiations, and strategic benefit plan adjustments based on plan performance.

• Monitor and analyze claims data, utilization trends, funding arrangements and savings reports to identify drivers and recommend plan design modification and/or strategies to meet goals.

• Conduct regular client meetings to proactively recommend strategies for success throughout the life of the client and increase client knowledge of Self Fund Health’s best practices.

• Identify process improvement opportunities to enhance client satisfaction and operational efficiency.

Qualifications:

• Location: Wisconsin-based remote, with an understanding of Wisconsin's and surrounding states healthcare, health insurance and broker landscape.
• Relevant Experience: Minimum of 3-5 years of health insurance industry experience in account management, benefits consulting, or a related field.
• Client Retention Experience: Proven client retention success including meeting and exceeding goals, successfully negotiating contracts, exceeding client satisfaction expectations and managing clients in a fast-paced environment.
• Health Insurance Knowledge: In-depth understanding of health plan benefits, self-funded plans, stop loss insurance, medical claims processing, network structures, cost-containment strategies, population management, risk management, DPC models, free-market care, engagement strategies, compliance, familiarity with ERISA, ACA, HIPAA, COBRA and other health plan regulations, and experience analyzing claims data is preferred. Foundational health insurance knowledge is required.
• Client Relationship Management Expertise: Demonstrated strong relationship-building and client service orientation with excellent communication, presentation, negotiating and relationship-building skills.
• CRM Proficiency: Familiarity with CRM systems for tracking onboarding activities and managing the client support.
• Passionate & Mission-Driven: Committed to Self Fund Health’s mission of transforming healthcare in Wisconsin and surrounding states, with a drive to make a difference in healthcare costs and outcomes for our communities.

Working Conditions:

• Remote Position: Flexibility to work remotely, with occasional travel required within Wisconsin and surrounding states to attend meetings and events.
• Collaborative Startup Environment: Engage with a team that values creativity, innovation, and the drive to make a positive impact. We encourage ideas, input and a growth mindset.

Benefits:

• Competitive base salary with performance based incentives.
• Professional development and career growth opportunities within a rapidly expanding startup.
• Supportive and dynamic work environment focused on innovation and healthcare transformation.
• Paid time off (PTO), holidays, among other benefits available.

Join us in our mission to transform healthcare and reduce costs for local businesses while driving client satisfaction and retention. If you're a relationship/service minded professional with a passion for making a difference in healthcare, we’d love to hear from you! Apply today to be vital part of the Self Fund Health team.

Self Fund Health is an equal opportunity employer.