Eligibility Verification Manager

Part D Advisors (PDA) is a custom solutions provider that recovers lost funds and generates future savings in healthcare costs. With a breadth of experience in both Retiree Drug Subsidy (RDS) administration and Dependent Eligibility Verification audit (DEV/DEVA) services, we’ve collected more than $1 billion in subsidies for our RDS customers, and produced an average ROI of $28 to $1 for DEV clientele. In short, PDA reduces healthcare costs without reducing member benefits or raising premiums.

As part of Gallagher, a global leader in insurance, risk management, and consulting, you’ll be joining a team that’s passionate about helping individuals and organizations thrive.

The Manager will be responsible for directing all facets of eligibility and enrollment verification, customer relations, and processing center operations. Oversees and trains the Account Managers and Processing Center Supervisors. Works with other team members to assure there is smooth client intake, project planning, and project execution is on schedule and on budget. Functions as liaison to key accounts and brokers. Demonstrates a high level of personnel management expertise, personal initiative, excellent communication and interpersonal skills, and strong organizational skills. Ensure that we successfully complete Dependent Audit contractual obligations, including tracking of service level agreements. Coordinates with Account Management staff to maintain overall positive client, broker, and vendor relationships.  Confirms that we have effective documentation and output for the services that we offer and in the deliverables that we provide for both internal and external use. Delegates accounts receivable activities with the Dependent Audit Account Management Team. Possesses a high level of subject matter expertise and serves as a resource to direct reports. 

This is a hybrid position and the salary range for this role is $83,000 - $93,000.00

• Coordinates and manages the oversight of the Dependent Eligibility Practice.
• Recruits and trains Account Managers and Processing Center Supervisors.  
• Builds a business partnership with each assigned customer based in trust and confidence that their needs are met, and any issues will be addressed and resolved in a timely and professional manner.
• Functions as liaison to key accounts and brokers. Lead the design and customization of customer verification forms, survey questions, and affidavits.
• Proactively anticipates and resolves customer and referrer issues and oversees “end to end” total issue resolution thereby ensuring customer satisfaction.
• Participates in scrum sessions with the Business Process Team to help guide software development and implementation.
• Coordinates Accounts Receivable follow-up and reporting in conjunction with the Accounting Team.
• Maintains the confidentiality of corporate records and our financial positions in strict confidence.
• Ability to quickly learn computer software and features, research and gather a variety of information, then organize and distribute into a presentable and easy to follow format.
• Provides and regularly applies project management and analytical skills to processes and deliverables, and helps to proactively identify where internal processes can be improved upon.  
• Performs other duties as assigned or as business needs are expanded.

Required: Bachelor's degree with 5+ years client service and/or claims management experience -OR- High School degree/GED with 10+ years client service and/or claims management experience. 3+ years supervisory experience. 

• Excellent skills with Microsoft Windows (current version), Microsoft Office applications, particularly in Word and Excel, and a familiarity or experience with other computer software programs.
• Exceptional overall computer literacy skills, including file organization, finding tools to accomplish routine goals, and personal management via Microsoft Outlook.
• Excellent writing, communication and interpersonal skills.
• Strong leadership skills and the ability to successfully mentor and manage the department and staff, collaborate with other departments and managers, regularly applying business judgment to the application of our company policies and procedures.
• Ability and passion to learn the business and industry, to assist in the support and development of our various service offerings. and in the future development of new products or services, and to continually support the corporate strategic direction.
• Ability to work in a team environment, show strong initiative, foster positive relationships, and to effectively participate on project teams as needed.
• Strong customer service skills, and the ability to successfully demonstrate effective outcomes.
• Must be able to learn new technologies, utilize basic office equipment, and evaluate different software tools as deployed internally.
• Excellent organizational skills and time management skills, and the ability to effectively communicate with external contacts including clients, brokers, third party administrators in fostering positive relationships.
• Must be able to handle confidential and sensitive information securely and appropriately.
• Experience in utilizing customized computer software in previous positions, with the strong ability to learn and effective operate within the company’s systems and custom software programs.
• Ability to demonstrate original thinking, initiative and creativity, and to communicate within management guidelines to develop innovative approaches and ideas.

We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. 

Below are the minimum core benefits you’ll get, depending on your job level these benefits may improve:

• Medical/dental/vision plans, which start from day one!
• Life and accident insurance
• 401(K) and Roth options
• Tax-advantaged accounts (HSA, FSA)
• Educational expense reimbursement
• Paid parental leave

Other benefits include:

• Digital mental health services (Talkspace)
• Flexible work hours (availability varies by office and job function)
• Training programs
• Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing
• Charitable matching gift program
• And more...

**The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process.

We value inclusion and diversity

Click Here to review our U.S. Eligibility Requirements

Inclusion and diversity (I&D) is a core part of our business, and it’s embedded into the fabric of our organization. For more than 95 years, Gallagher has led with a commitment to sustainability and to support the communities where we live and work.

Gallagher embraces our employees’ diverse identities, experiences and talents, allowing us to better serve our clients and communities. We see inclusion as a conscious commitment and diversity as a vital strength. By embracing diversity in all its forms, we live out The Gallagher Way to its fullest.

Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non-conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected (herein referred to as “protected characteristics”) by applicable federal, state, or local laws.

Equal employment opportunity will be extended in all aspects of the employer-employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.