SUMMARY
The Health Benefits Risk Pool (“Pool”) Account Executive is responsible for retaining Pool membership by building and maintaining strong relationships with members (the insured). They act as a trusted advisor, facilitating strategic discussions on health benefit design decisions within budgetary constraints. The Account Executive promotes member engagement and loyalty by highlighting the Pool's value and benefits and educating members on programs for better outcomes and lower costs.
They employ a consultative approach to understand member needs and develop recommendations. Responsibilities include pre-renewal strategic discussions, performance reporting, renewal negotiations, and ensuring exceptional customer service, working closely with the Account Manager. The Account Executive presents company products and services and assists brokers/consultants with presentations, staying informed about competitor products and industry trends.
ESSENTIAL DUTIES AND RESPONSIBILITIES - include the following. Other duties may be assigned:
- Develop and maintain a positive working relationship with Benefit Coordinators and decision makers of assigned groups. Establishes and maintains a high level of trust and confidence with groups, their employees and respective brokers/consultants.
- Performs strategic quarterly, semi-annual, and pre-renewal reviews, interpreting claim reports and providing aa consultative approach to understand member needs and develop personalized recommendations to groups as appropriate.
- Coordinates with and delegates to Account Manager service issues that may arise from the Benefit Coordinator, broker/consultant or decision maker. Follows up on service issues that have been delegated to Account Manager and tracks progress to ensure timely and accurate resolution of issues.
- Present a positive image of TX Health Benefit Pool and serve as a “champion” for TXHB.
- Communicate with the Director of Marketing and Senior Marketing Manager of new and changes of current Member Group / Broker relationships in addition to sharing potential new opportunities to strategize on continued market growth within the Territory and Region.
- Works closely with the Account Manager throughout the existing group renewal process, ensuring renewal paperwork is accurate, timely, and complete per established timelines.
- Provides competitive analysis and market vulnerabilities feedback from Member Groups and Broker/Consultants to the Sales Executive and Marketing Manager for assigned groups.
- Attend regional and council meetings, bid openings when and where possible at the Senior Marketing Manager and Marketing Leadership’s request.
- Proactive education and dialogue with Benefit Coordinators to ensure appropriate and timely decisions related to benefits and services.
- Promotes webinar education, Benefit Coordinator training, wellness events, and regional meetings to encourage attendance/participation.
- Maintains daily and accurate documentation in appropriate systems (Salesforce, Member Database, etc.) Document all interactions with Member groups in Salesforce or other systems as appropriate. Ensure that cases are set up on a timely basis, referred to the appropriate party, and tracked throughout the process for resolution.
- Conducts open enrollment meetings to provide member education, enrollment, benefit updates.
- Work in cooperation with Account Manager to create, edit, and share targeted group reporting packages and presentation slide decks for open enrollment, strategic meetings, and other group meetings as assigned.
- Protects the confidentiality, integrity and availability of information and records that TXHB Health creates, receives, maintains, or transmits by complying with TXHB Health policies and procedures, including policies and procedures on physical, administrative, and technical safeguards.
- Physical safeguards are physical measures, policies and procedures that protect TXHB buildings, equipment, and information systems from natural and environmental hazards and from unauthorized intrusion.
- Administrative safeguards are administrative actions, policies, and procedures that: (1) manage TXHB’s selection, development, implementation, and maintenance of measures that protect TXHB’s information and records; and (2) manage the conduct of TXHB employees in protecting the privacy and security of TXHB’s information and records.
- Technical safeguards are the technology and policies and procedures for its use that protect electronic information and records and that control access to electronic information and records.
- Assist with new projects and other duties as assigned in the department.
KNOWLEDGE/SKILLS/ABILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
- Proven success renewing and retaining client’s book of business.
- Ability to develop strategic competitive market analysis.
- Ability to compile, analyze and evaluate complex information, including claims data and reporting, to facilitate decision-making.
- Exceptional communication and presentation skills and/or public speaking experience.
- Ability to facilitate collaborative teamwork, with supportive leadership and mentoring skills.
- Strong organization skills, ability to manage multiple priorities and strong follow-through.
- Ability to meet all sales/service requirements at corresponding range criteria percentile.
- Must be able to travel frequently, including overnight stays within Texas as necessary, to meet face-to-face with groups, attend regional meetings, TXHB Board Meetings, and other meetings as required. Expected travel is 2-3 days per week on average, depending upon renewal schedules. Based on this travel requirement, the role is eligible for a company vehicle or a vehicle allowance.
- Full proficiency in the use of Salesforce and Microsoft Office (Word, Excel, PowerPoint, Teams, etc.).
- Technical ability to utilize TXHB online to look up group information and review historical documentation.
- Thorough knowledge of current underwriting procedures for financing arrangements and benefit structures including and not limited to PPO, HMO, and HDHPs for fully insured groups.
- Thorough understanding of all TXHB benefits and services, including medical benefits, pharmacy benefits, surgery benefits, vision benefits, dental benefits, spending accounts and Consumer Directed Health (CDH) plans.
- Practical knowledge of relevant laws and compliance regulations, including COBRA, HIPAA, handling Personal Health Information (PHI), etc.
EDUCATION/EXPERIENCE
Required
- Texas General Lines license—life, accident, health, and HMO Insurance License, preferred
- 3 -5 years of experience in sales, account management, or benefit plan management for fully insured health benefits and/or insurance products
- 3 – 5 years of experience working with a variety of healthcare plans and administrative services with familiarity of general healthcare underwriting process for fully insured group health plans.
- A strong working knowledge of the changing vendor landscape including new entrants into the marketplace and cutting-edge products and solutions.
Preferred
- 5 years of experience servicing or selling group health benefits administration, stoploss and/or insurance products.
- Bachelor’s degree or the equivalent healthcare/benefits/insurance environment experience, or combination thereof for self-insured and fully insured groups.
- Experience in guiding benefit design decisions, funding strategy, etc.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Ability to speak/hear clearly to communicate by phone or in person.
- Ability to frequently stand, sit and walk.
- Ability to frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds.
- Ability to travel on a regular basis.
- Valid Texas driver’s license and ability to drive throughout the state for in-person visits
Flexible Work Arrangements
☒ 100% Remote - onsite as required (MON- FRI)
Work Schedule
☐ 8:00 AM - 5:00 PM (MON- FRI)
