SEIU Local 32BJ is the largest labor union representing property service workers in the United States, with over 145,000 members across 11 states. Its membership is made up of the men and women who provide services primarily at commercial and residential properties, including office cleaners, door people, window cleaners, maintenance workers, food service workers, and security officers, among others. Union contracts provide generous benefits to members including: health benefits, access to legal services, retirement benefits and job skills training, which are provided and managed by the Building Service 32 BJ Benefit Funds (“Funds”).
The 32BJ Health Fund is the 32BJ Taft Hartley fund that provides health benefits for nearly 200,000 people. Through the Health Fund, union members and their dependents access affordable and high-quality health benefits including: hospital and medical, prescription drug, dental, vision, short and long term disability, and life insurance. Most of the benefits are self-insured with an annual spend of more than $1 billion and are provided through ASO arrangements with vendors such as Empire BlueCross BlueShield and CVS Caremark. The Fund also owns and operates an on-site dental clinic to provide dental services directly to members and their dependents.
32BJ Benefit Funds is seeking a highly skilled manager with deep knowledge of healthcare operations and systems to become its nest Director of Health Fund Operations. Reporting to the Deputy Director of the Health Fund, the Director of Health Fund Operations plays a critical role in overseeing the day-to-day provider-related and member-related operations that support the Fund’s strategic programs to deliver cost effective and high-quality health care coverage to its plan participants. The right candidate will have a proven track record of high-level project management/operations experience for significant institutions involved in healthcare delivery, and/or health insurance.
The Director of Health Fund Operations will work with other Fund Senior Staff to manage the internal operations of the Health Fund; manage relationships with health care providers; understand and analyze health care trends; provide support to union delegates in communicating with members about the Health fund; provide counsel and advice to staff and senior management on all of these matters; and help implement policies set by the Trustees.
The Director of Health Fund Operations will manage a team of people with diverse skills. Director of Health Fund Operations candidates must be adept leaders with an ability to develop colleagues aligned with organizational values of accountability and autonomy. Further, the successful candidate will have strong interpersonal, customer service and collaborative skills, excellent written communication and verbal presentation skills, a hands-on management style, and the ability to address and solve problems or issues proactively. In addition, he or she should be diplomatic, an active problem solver, and possess sound judgment as well as an appropriate sense of humor.
Principal Duties and Responsibilities:
- Manage relationships with health care providers who serve as 5 Star Centers and other 32BJ Partners, in order to provide Health Fund participants with access to high-quality, cost-effective care.
- Manage protocols for responding to inquiries and complaints received from providers and Fund participants specific to 5 Star Centers and other 32BJ Partners.
- Act as a liaison between the Fund and its Third-Party Medical/Hospital Administrator to resolve inquiries and complaints from providers and members about claims and network participation.
- Maintain and monitor processes to enroll members into unique benefit programs, such as the 5 Star Wellness Program which encourages Health Fund participants with chronic conditions to seek high quality primary care and maintain compliance with their prescription medication.
- Supervise the Health Services Unit. The staff in this unit provide concierge level service in assisting members with: making appointments at 5 Star Centers; resolving billing and provider issues at 5 Star Centers; enrolling participants into the 5 Star Wellness program; identifying in-network providers for all types of medical care; answering questions about specific and complex aspects of the benefits; and informal dispute resolution on billing issues and benefit coverage.
- Supervise the Clinical Manager who negotiates out-of-network bills for emergency services.
- Supervise the Marketing and Relationship Manager who manages the relationship with 5 Star Centers and takes the lead on Health Fund marketing materials.
- Supervise the Social Work team which assists members in: accessing services through specific 32BJ Partners; transitioning from active coverage to Short Term Disability, Long Term Disability, Cobra, or other sources of coverage.
Other Duties and Responsibilities:
- Collaborate with leadership to design benefit changes that focus on quality and bend the health care cost curve without shifting costs to members.
- Supervise a continuous quality improvement program that determines operational targets, measures performance, and improves program outcomes. As needed, advise management about systematic problems that pertain to members and the providers from which they seek care.
- Coordinate resources with other departments to efficiently deliver benefits.
- Assist with the development and implementation of special projects which are meant to improve health outcomes and reduce the cost of providing health benefits
- Leadership and Project Management: a proven leader with senior level experience in project management and operations on a large scale with the ability to manage a diverse and dynamic set of team members on an individual and corporate level. This includes maintaining high levels of work ethic and standards.
- Collaboration and Leadership: ability to collaborate successfully with internal and external constituencies, including the senior management of the 32BJ Health Fund, the executive management team of the 32BJ Benefit Funds, the Compliance Department, trustees, lawyers, consultants, senior staff and others.
- Mentorship: ability to and interest in developing the leadership capacity of staff.
- Problem Solver and Entrepreneurial: a critical thinker, especially with experience in sound problem-solving and decision-making skills to meet operational needs.
- Excellent Communication Skills: demonstrated ability to communicate clearly, both written and verbal, while maintaining an acute discernment of audience.
- Bachelor degree required; MBA, MPH, or MPA strongly preferred
- Minimum of 7 years related experience
- Ability to manage the work of different units to meet the goals within tight timeframes
- Well organized with acute attention to detail and able to simultaneously manage and prioritize projects and meet deadlines
- Knowledge and experience with systems.
- Extensive experience in customer service in the health care field or similar
- Ability to plan and implement program initiatives in a timely manner
- Knowledge of the laws and regulations, trends and best practices in the health insurance and health care delivery fields
- Ability to use technological tools, such as spreadsheets and databases, to analyze trends and solve problems
- Ability to proficiently use MS Office and databases.
- Ability to work independently, as well as part of a team, prioritizing workflow to meet critical deadlines
For more information about Building Service 32BJ Benefit Funds, please visit their website at www.32bjfunds.org.
All positions at Building Service 32BJ Benefit Funds are filled without regard to race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, disability, HIV/AIDS status, veteran status or any other characteristic protected by law. All are encouraged to apply.
How to Apply
Building Service 32BJ Benefit Funds has retained the services of Harris Rand Lusk to conduct this search. Inquiries, nominations, and applications may be directed in confidence to:
Anne J. McCarthy, Senior Director/COO
Harris Rand Lusk
122 East 42nd Street, Suite 3605
New York, NY 10168
Please put “32BJ Health Fund Operations” in the subject line of your e-mailed application.