Director of Health & Welfare Operations

The Chicago Laborer’s District Council Benefit Fund Office is seeking a Director of Health and Welfare Operations to oversee the day-to-day operations of two Taft-Hartley Health & Welfare Plans covering approximately 40,000 hard working Laborers, retirees and their dependents. The Plans include medical, prescription drug, weekly disability income, death benefits, AD&D benefits, dental, vision, member’s assistance and diabetes management programs.

The Health and Welfare operations include customer service, medical claims processing, imaging center and coordination with outside vendors to ensure that the Plans are administered according to the plan documents and federal regulations. The Director of Health and Welfare Operations is responsible for the management of 40+ staff members, including collectively bargained staff, and will work collaboratively across all departments within the organization, plan professionals, the Boards of Trustees and other stakeholders. The ideal candidate thrives in a fast-paced environment where managing a number of tasks and priorities at the same time is critical to success.

The position requires a minimum of ten (10) years of benefits related experience and a minimum of five years (5) of supervisory experience. Previous experience in the Health & Welfare industry is required, including a strong working knowledge of benefit program design and management, Collective Bargaining Agreements, Plan governance documents and DOL compliance. Direct experience with benefit vendors and consultants is required.

This is a permanent, full-time position that offers excellent pension, 401(k), health, dental, and vision benefits. Regular work hours are Monday through Friday from 8:30 a.m. to 5:00 p.m. however, job duties may require flexibility as needed. If interested in applying please email the Human Resources Department at [email protected].

Areas of Responsibility:

Day-to-Day Management

• Oversee maintenance of Plan participant records, including member demographics, eligibility and claims.
  
• Develop and maintain procedures for benefit administration processes.
  
• Ensure that policies, procedures and reporting comply with Plan rules and government regulations.
  
• Work collaboratively within the department, across departments, with plan professionals (including attorneys, consultants and auditors), vendors and stakeholders.
  
• Act as subject matter expert for the Plans, including researching, analyzing and resolving benefit issues or inquiries escalated by members and other stakeholders.
  
• Develop and maintain reporting metrics to analyze and benchmark Plan, vendor and operational performance.
• Prepare and present the results to Trustees and other stakeholders.
  
• Prepare and present participant benefit appeals.
  
• Oversee management of projects to ensure deliverables are met on time with high quality and within approved budget.
  
• Monitor and evaluate department activities, assess and document performance including identifying problems and providing appropriate resolution.
  
• Develop and monitor progress reports for team members to assess or quantify performance.
  

Supervisory

• Manage a staff of 40+ bargained and non-bargained employees, including overseeing performance evaluation cycles.
  
• Participate in hiring, discipline and termination decisions as needed.
  
• Develop and evaluate employee performance metrics.
  
• Develop and review staffing levels to ensure that services are provided accurately and efficiently.
  
• Oversee training and mentorship of staff.
  
• Maintain a positive work atmosphere by acting and communicating in a manner that instills good working relationships with co-workers, Plan participants, vendors, Plan professionals, Trustees and other stakeholders.
  

Program Management

• Coordinate benefit communications (enrollment materials, SPDs, brochures, guides, online materials, videos and presentations).
  
• Assess current health care programs, market trends, legislative, tax and social changes that impact current programs. Must obtain product/vendor knowledge through training and self-initiated education.
  
• Ensure that H&W program design, administration, policies and communication strategies are designed with the member’s need first and are communicated in a way that is positively received.
  
• Coordinate project activities and deliverables across different service providers (group health plan, PBM, dental, vision, MAP, disease management, etc.)
  

Vendor Management

• Manage all aspects of vendor relationships including the delivery of related activities.
  
• Prepare data used for cost projections, vendor renewals and actuarial valuations – gather and evaluate data from vendors for contract renewals and new program proposals.
  
• Work with health benefit vendors to administer and resolve administrative and claim payment issues.
  
• Develop and monitor progress reports of vendors to assess or quantify performance.
  
• Review, analyze and approve vendor invoices according to contract terms.
  

Experience/Education/ Certifications:
The position requires a minimum of ten (10) years of benefits related experience and a minimum of five years (5) of supervisory experience. Previous experience in the Health & Welfare industry is required. Bachelor’s degree in related field or commensurate practical experience required. CEBS, MBA or advanced degree preferred.

Skills:

• MS Office Tools: Proficiency in Microsoft Word, PowerPoint, Outlook, Teams is required. Advanced proficiency in Excel (creating, formatting, and evaluating formulas, pivot tables and working within templates, etc.) is required.
  
• Working knowledge of regulatory environment: ERISA, HIPAA, COBRA, ACA, MHPAEA, DOL, GINA, and other state and federal employee benefit regulations. Must have the ability to analyze and implement changes to Plan rules and procedures to ensure compliance with existing and new regulations.
  
• Possess curiosity for health care trends, products, services, technical tools, and resources and self-directed ability to participate in training courses, online learning or through vendor education programs.
  
• Must be customer focused, have excellent organizational, communication, time management, problem solving, decision making, follow-up and follow-through skills.
  
• Possess strong oral and written communication skills, including the ability to design and deliver effective group presentations using various media.
  
• Proven experience successfully managing multiple projects simultaneously and producing quality deliverables on time and within budget.
  
• Ability to assess situations and derive innovative and practical solutions to complex problems, using root cause analysis, data analytics and solid judgment in a fact-based, detailed oriented manner.
  
• Ability to manage staff with mature judgment to encourage, counsel, mentor and resolve conflict when necessary.