Moda Health

Manage and direct the sales team, oversee product service and financial growth, lead RFP responses, coach staff, and coordinate cross-department communication. | Bachelor’s degree or equivalent, 5-7 years marketing/sales/supervisory experience in health insurance, strong communication, project management, and industry knowledge. | Let’s do great things, together! About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together. Job Summary: Manage and direct the Moda/DDOR Sales team including day-to-day leadership, strategy, training, and support to staff. Coordinates communication to all producers/consultants. Manage service of our products and manage assigned staff to assure the financial and membership growth of Moda, DDOR and BenefitHelp Solutions. Primary BHS responsibilities include the servicing and cross selling of Cobra Administration, FSA, HRA, Retiree Premium Administration, staff training and hiring, presentations to brokers and groups. Manages the request for proposal team including strategy, oversight of key dates/deliverables. This is a full-time hybrid position based in Portland, Oregon. Pay Range $92,940.40 - $118,497.46 (annually) depending on experience. Position eligible for incentive. Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Please fill out an application on our company page, linked below, to be considered for this position. https://j.brt.mv/jb.do?reqGK=27764196&refresh=true Benefits: • Medical, Dental, Vision, Pharmacy, Life, & Disability • 401K- Matching • FSA • Employee Assistance Program • PTO and Company Paid Holidays Primary Functions: • Manage and direct the team by providing daily work direction, vacation scheduling, monitoring attendance, giving performance reviews, and hiring and training new employees. Continues to ensure and participate in agent training. • Manage implementation process associated with new products. • Lead project manager on special projects as assigned. • Lead sales and service communication initiative/strategies internally and externally. • Coach and motivate Sales teams to increase new group sales, ensure the retention of existing accounts and provide good service to our accounts. Ensure the Underwriting regulations are adhered to and groups are enrolled efficiently, as well as renewals are completed in a timely fashion and meeting the advance notice requirements. • Act as Sales Representative and service representatives in their absence. Meet with agents and representatives regarding difficult renewals, assist with prospective account sales and new group transitions. • Lead projects and facilitate communication between internal departments (and external clients if appropriate) to ensure productivity standards and sales goals are exceeded and deadlines are met. • Directing RFP responses for Moda Health, Delta Dental and BenefitHelp Solutions; this includes managing specialist workload, training & development of RFP staff including support and guidance throughout the process. • Improving RFP response tools such as style guide, SME assignment guides, content development outside of RFP cycle, etc and ensuring they are current and up to date. • Directing strategic development of RFP response library: developing and improving procedures for updating library content, strategy for review cycles, etc • Provide input and strategy towards company decisions on which RFPs to bid on (i.e. analysis of resource use vs likelihood of winning), and how best to win them. • Oversee transition and implementation process for new and renewing business. • Provide management support in the absence of other sales and service management staff. • Work with the sales & service management teams to set sales objectives and develop an annual marketing plan to meet those objectives. • Work with the sales & service management teams to develop an annual budget. Plan for and use the resources within the calendar year to support the budget. • Responsible for the review and dissemination/utilization of marketing literature. • Provide support to Marketing & Informatics team as needed to integrate new products, business partnerships and ancillary products into ODS’ business portfolio. Integration to include implementation and communication. • Represent the sales & service management team on internal and external committees. • Produce monthly, quarterly and annual reporting & analysis on sales results, opportunities, wins, losses and communicate those more broadly throughout the organization. • Provide back-up support Required Skills & Experience: • Bachelor’s degree or equivalent, and 5-7 years marketing/sales/supervisory experience in the health insurance industry. • Strong verbal, written, and interpersonal communication skills. • Strong statistical, analytical, problem solving, organizational, and detail orientation skills. • Strong project management and organization skills. • Strong creativity and vision. • Ability to lead, motivate and develop staff. • Strong presentation skills. • Knowledge of Medical Dental, Vision and Pharmacy insurance business as it relates to processing of claims, handling of billings, customer service, and related information. • Maintain confidentiality and project a professional business image. • Ability to work well under pressure; work with frequent interruptions and shifting priorities. • Computer proficiency preferably with Microsoft Word, Excel, and PowerPoint. • Ability to handle a pushcart/hand truck and be able to lift boxes up to 40 lbs. in and out of a car trunk. Contact with Others & Working Conditions: • Office environment with extensive close PC and keyboard use, constant sitting, and frequent phone communication. Must be able to navigate multiple computer screens. A reliable, high-speed, hard-wired internet connection required to support remote or hybrid work. Must be comfortable being on camera for virtual training and meetings. Work in excess of standard workweek, including evenings and occasional weekends, to meet business need. • Internally with multiple departments and levels of staff. Externally with business partners/vendors, producers, consultants, groups, and subscribers. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our humanresources@modahealth.com email.

Lead and monitor credentialing and re-credentialing processes ensuring compliance with NCQA and state/federal requirements in a hybrid work environment. | Bachelor’s degree, 2+ years in health plan or similar with provider credentialing experience preferred, typing and ten key proficiency, strong organizational skills, and knowledge of NCQA and related standards. | Let’s do great things, together! About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together. Job Summary Responsible for leading, coordinating, monitoring, and maintaining the credentialing and re-credentialing process in accordance with Moda policies, National Committee for Quality Assurance (NCQA) standards and state and federal requirements. This is a FT hybrid position based in Portland, Oregon. Pay Range $22.88 - $25.74 hourly, DOE. • Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Please fill out an application on our company page, linked below, to be considered for this position: https://j.brt.mv/jb.do?reqGK=27763295&refresh=true Benefits • Medical, Dental, Vision, Pharmacy, Life, & Disability • 401K- Matching • FSA • Employee Assistance Program • PTO and Company Paid Holidays Required Skills, Experience & Education • Bachelor’s degree or equivalent specializing in health or business. • 2+ years’ experience working in a health plan or similar organization. Provider credential experience preferred. • Type a minimum of 50 wpm on computer keyboard. • Ten key proficiency of 135 kspm net. • Strong organizational and time management skills. • Ability to work well under pressure, meet deadlines, produce a high volume of work and work independently as well as in a team environment, with shifting priorities. • Ability to problem solve, retain information and have strong attention to detail. • Proficient in Microsoft Office applications with the ability to learn internal computer systems. Working knowledge of crystal reports desired. • Working knowledge of NCQA, the Centers for Medicare and Medicaid Services and Oregon Health Authority or other state credentialing standards helpful. • Excellent verbal, written and interpersonal skills. • Ability to maintain confidentiality and project a professional business image. • Ability to come in to work on time and on a daily basis. Primary Functions • Performs oversight of credentialing delegates to ensure compliance with our oversight bodies. • Generating and distributing credentialing reports. • Identifies and reports any non-compliance or credentialing issues to the credentialing supervisor. • Monthly monitoring of provider license action and sanction information. • Assures confidentiality of documents, records and data information. Keeps all documents secure and confidential. • Collection of needed verification from all relevant licensing bodies. • Approved application process and reporting. • Performs other duties as assigned. Contact With Others & Working Conditions • Internally with all departments. Externally with vendors, providers, health professionals and physician offices, IPA, Delegates, Rented Networks, Hospitals and Licensing boards. • Office environment with extensive close PC and keyboard work, constant sitting, and phone work. Must be able to navigate multiple screens. May work in excess of 37.5 hours per week, including evenings and occasional weekends, to meet business need. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations please direct your questions to Kristy Nehler and Danielle Baker via our humanresources@modahealth.com email. #INTONLY

Coordinate complex accounts, provide technical support and training, back up supervisory duties, and monitor unit performance in a hybrid office environment. | High school diploma, 12 months membership accounting or equivalent experience, Microsoft Office skills, leadership ability, strong communication and organizational skills. | Let’s do great things, together About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together. Position Summary Coordinate and handle complex accounts and be a point of contact for external (CMS, FFM, CCO/DCO, Employer Groups, etc.) and internal constituents; provide back up for Supervisor and assists the Supervisor in monitoring unit performance relative to key objectives; provide on-going technical support and back up for all eligibility, billing and reconciliation for the unit; be a model of leadership, help guide and develop your team; identify, develop and conduct unit training needs on a primarily individual basis for all existing employees and backs up the trainer for all new employees. This is a full-time hybrid position based in Portland, Oregon. Pay Range $25.08 - $28.21 hourly, DOE. • Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Please fill out an application on our company page, linked below, to be considered for this position • https://j.brt.mv/jb.do?reqGK=27762592&refresh=true Benefits: • Medical, Dental, Vision, Pharmacy, Life, & Disability • 401K- Matching • FSA • Employee Assistance Program • PTO and Company Paid Holidays Required Skills, Experience, & Education: • High school diploma or equivalent. • Computer proficiency with Microsoft Office applications. • Typing proficiency of 35 wpm preferred. • 10 key proficiency of 135 spm on a computer numeric keypad/calculator preferred. • 12 months experience as a Membership Accounting Specialist, consistently exceeding all levels of performance or equivalent experience preferred. • Familiarity with Moda and/or BHS enrollment, billing, reconciliation and other operational systems and workflows preferred. • Ability to train others and present information in a well thought out and easily understood fashion. • Strong verbal, written, and interpersonal communication skills and ability to interact professionally, patiently, and in a positive manner with internal and external customers. • Ability to instruct, motivate and direct individuals at various skill levels, and various personality types, face to face an in the classroom environment. • Strong analytical, problem solving, decision making, organizational, and detail orientated skills. • Ability to work well under pressure and set priorities in a complex and rapidly changing environment. • Maintain confidentiality and project a professional business image. • Good to great leadership skills, previous leadership experience preferred. • Ability to work with frequent interruptions and demonstrate professional leadership qualities. Self-motivated, requiring little to no guidance or direction. Primary Functions: • Identify, develop, and conduct unit training needs primarily on an individual 1:1 basis. • Assist Membership Accounting Specialists in problem solving and problem resolution. Provide on-going technical support to unit and acts as a liaison with other departments. • Coordinate new group set-up for the more complex accounts, this includes but not limited to verification of the group application, meeting with group administrators and participating in installation meetings with Sales, BIU, IT and Marketing personnel. • Provide back up for supervisory duties and be a model of Leadership to your department while guiding and developing the Membership Accounting specialists. Could include assuming the role of interim supervisor for the unit. • Provide back up to the Membership Accounting Trainer and all Membership Accounting Specialists in the unit. • Assist in updating department policies and procedures. • Administer quality control audits for established unit staff. • Monitor unit performance relative to key objectives and turnaround time. • Handle special projects and assignments as determined by Management including the development of new programs and associated documentation. • Other duties as assigned Working Conditions & Contact with Others: • Internally with all departments and all levels. Externally with Group Administrators, TPA’s, State and Federal Regulators, Members, Auditors and Agents. • Office environment with extensive close PC and keyboard work, constant sitting, and phone work. Must be able to navigate multiple screens. Work in excess of 37.5 hours per week, including evenings and occasional weekends, to meet business need. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations please direct your questions to Kristy Nehler & Danielle Baker via our humanresources@modahealth.com email.

Lead and manage a team responsible for configuring benefits into core processing systems, overseeing projects, training, documentation, and ensuring quality and efficiency. | Bachelor’s degree or equivalent experience, 5+ years supervisory experience, 5+ years benefit configuration experience with Facets Extended Enterprise, strong technical skills including SQL and Excel, health plan operations preferred. | Let’s do great things, together! About Moda Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together. Job Summary This position is responsible for the leadership of the team that configures all benefits (including, but not limited to, medical, dental, vision, pharmacy etc.) into our core processing system. This includes definition, planning, design, development, improvement, integration and/or maintenance of the company’s benefits and products. Responsible for resource allocation, setting deadlines, and managing multiple priorities simultaneously. Also responsible for configuration activities in other systems that drive web tools for our providers and members, as well as those used by our product development team. Manages the department through standard day to day work as well as a high volume of planned projects annually, and ad-hoc projects that arise through the course of business. Assures that there is appropriate training and documentation for the team, and coaches staff to success in their positions. This is a full-time hybrid position based in Portland, Oregon. Pay Range $92,940.40 - $118,497.46 (annually) depending on experience. Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range. Please fill out an application on our company page, linked below, to be considered for this position. https://j.brt.mv/jb.do?reqGK=27761902&refresh=true Benefits • Medical, Dental, Vision, Pharmacy, Life, & Disability • 401K- Matching • FSA • Employee Assistance Program • PTO and Company Paid Holidays Primary Functions • Manages a team of 10-15, including coaching, mentoring, and skill development for staff to be successful in their positions. • Manages and tracks the flow of work from various channels, communicating expectations to requestors and management as appropriate. • Sets priorities within the team, and monitors progress. • Establishes departmental standards (quality, productivity, documentation etc.), and monitors results. • Evaluates and modifies policies and processes, to assure the highest level of efficiency and quality outcomes. • Leads staff through frequent and challenging changes in priorities and processes. • Analyzes product business requirements, develops, and evaluates alternatives, prepares proposals and design specifications for complex benefit configuration systems or applications to meet operations identified needs, goals, and metrics. • Evaluates proposals and recommendations for complex benefit configuration, considering cost/benefit and resource requirements. • Develops the configuration strategy and architecture, balancing business need and the sustainment of configuration efficiencies. • Evaluates and makes decisions about the design of solutions which result in efficient, accurate, and quality configuration and maintenance of the company’s core and integrated systems. • Oversees the coding, testing, implementation, and maintenance of benefit configuration systems to meet client needs. • Schedules resources, translates major client requirements into configuration modifications; develops, plans, and schedules for major configuration projects to ensure client satisfaction. • Effectively communicates requirements, plans, and schedules to business stakeholders. • Participates with key stakeholders and clients in development of test plans and execution of testing configuration system changes/enhancements. • Analyzes and evaluates objectives, solves problems, and develops requirements and proposals for configuration systems and applications. • Development of new configuration concepts; performs analysis and improvement of existing techniques. • Ensures configuration decisions and changes are documented, timely, and in accordance with departmental standards. • Responds to inquiries from throughout the organization regarding existing configuration, potential configuration, and research for issues that are reported. • Keeps current with technical changes and improvements within areas of assignment, incorporating as needed. This includes participating on industry wide subcommittees sponsored by our system vendors. • Develops and maintains cross-functional expertise on configuration that crosses units/departments. Required Skills & Experience • Bachelor’s degree in business administration or a related field. Completion of an approved educational program or a minimum of four years of related experience may be accepted in lieu of a degree. • Minimum of five years of supervisory or management experience. • Proven ability to lead teams through significant and challenging changes. • Requires knowledge of advanced technology, business applications, development process, and systems design. • Minimum of five years of benefit configuration experience, specifically in Facets Extended Enterprise. • Proven ability to analyze and recognize potential business impacts for all affected departments with regard to benefit and/or contract changes, and to offer probable solutions or alternatives. • Health plan operations experience is strongly preferred. • Expert database/tools experience is strongly preferred (SQL, MS Access etc.). • Expert MS Excel skills are strongly preferred. • Must be proficient at writing system documentation from a business and technical perspective. • Experience developing tools to enable efficient configuration and analysis is required. • Strong verbal, written and interpersonal communication skills. Ability to listen and respond to information effectively. • Ability to work well under pressure work with frequent interruptions and shifting priorities. • Ability to come into work on time and on a daily basis. • Ability to plan, organize and prioritize tasks with competing priorities. • Ability to develop and deliver training. • Ability to develop and document unit process flows. • Ability to work independently, with minimal supervision. • Maintain confidentiality, and project a positive and professional business image. • Possess strong problem solving and decision making skills. Contact With Others & Working Conditions • Internally: with Regulatory, Sales, EPMO, Claims, Customer Service, Data Analytics, IT, management team and employees with frequently confidential information. Works with outside clients and vendors as needed. • Extensive PC work and constant shifting of priorities. • Work in excess of 40 hours per week, including evenings and occasional weekends, to meet business need. Together, we can be more. We can be better. Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training. For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our humanresources@modahealth.com email.