Account Manager, TPA

Responsibilities

• Serve as primary client contact: Act as the main point of contact for assigned clients, responding promptly to inquiries and providing creative solutions that meet client needs.
• Monitor service delivery: Track and manage service levels to ensure timely issue resolution, compliance, and adherence to contractual commitments.
• Prepare client reporting: Develop and deliver standard and custom client reports covering claims, utilization, and other key metrics for client review.
• Cook up internal resources: Partner with cross-functional teams across claims, eligibility, and compliance to meet client needs and deliver seamless service.
• Support strategic initiatives: Assist with renewals, plan changes, and strategic initiatives while supporting delivery of QBRs and renewal processes.
• Maintain documentation: Keep accurate client records, communication logs, and CRM system entries to ensure continuity and accountability.
• Escalate appropriately: Identify and escalate complex issues to Strategic Account Executive or Director when client needs exceed standard resolution pathways.
• Support client onboarding: Assist with new client onboarding and internal system setup to ensure smooth transitions.
• Stay regulatory-informed: Maintain knowledge of regulatory issues affecting benefit plans and proactively update clients when requirements change.

Qualifications

• Education & Experience: Bachelor's degree or equivalent in related discipline, 3+ years account management experience, 3+ years experience in health insurance, employee benefits, or healthcare industry, specifically with TPA/self-funded groups, prior TPA experience strongly preferred.
• Technical Skills: Knowledge of health plan testing, regulatory compliance, and insurance plan administration mandates, experience preparing client reports and presentations, proficiency with CRM systems for documentation and relationship management, ability to travel for multiple days at a time when needed.