Manager, Welfare Benefits
- Labor/Industrial Relations
A Taft Hartley fund, the New York City District Council of Carpenters Benefit Funds is a non-profit providing comprehensive, valuable benefits to over 25,000 working and retired union members and their families. The Benefit Funds exist for the sole benefit of its members and eligible dependents. The mission of the Benefit Funds Office is to properly administer the plans of benefits and deliver superior service to our members in all respects.
Through the Welfare, Pension, Annuity and Apprenticeship Funds, NYCDCC members enjoy health, vacation, and scholarship benefits, a defined monthly pension at retirement, a defined contribution benefit, and apprenticeship and journeymen training, all at little or no cost to the members.
The Funds office strives to maintain a balance of work and life. To that end, the Funds offers comprehensive benefits to its employees, including medical, dental, vision, annuity, generous PTO, holidays and a reasonable work schedule.
The Manager, Welfare is responsible for the management of the Funds’ staff of nine claims examiners and eligibility associates, as well as two Assistant Managers, who process benefit claims, such as disability, vision & hearing supplemental claims and vacation benefits. They also perform various tasks in connection with reconciliation of services, claims and billings for benefits provided by third party vendors such as for hospital, medical, dental, prescription, accidental death and dismemberment and life insurance benefits. The Manager also oversees compliance with the Funds’ eligibility rules and appeal procedures & actively participates in research, analysis and writing of welfare appeals.
Essential Job Functions:
- Responsible for all benefit materials that are distributed to participants including Summary Plan Descriptions (SPD’s), ensuring accuracy and compliance
- Oversees compliance of and adherence to plan design, policies, programs, procedures, contracts, coverage, reporting and disclosure requirements
- Ensures compliance by Welfare Department staff with various local, state, federal and governmental regulations including Employment Retirement Income Security Act (ERISA), Health Insurance Portability and Accountability Act (HIPAA), the Affordable Care Act, Health Care Reform, Consolidated Omnibus Budget Reconciliation Act (COBRA), Employer Group Waiver Plan (EGWP) coverage under Medicare, Mental Health Parity, the Patient Protection and Affordability Care Act (PPACA), and Medicare Secondary Payer in consultation with Fund Counsel as appropriate
- Assist in the development of internal procedures, guidance and training for staff to facilitate superior service to participants
- Ensuring efficient, timely and accurate workflow
- Manages nine direct reports, distributing workload & reviewing work, overseeing appropriate training and communicating performance feedback
- Monitors, reviews and approves all vendor billing
Knowledge, Skills and Abilities:
- Bachelor's degree (advanced degree and/or CEBS certification preferred)
- 5+ years’ experience in health and welfare benefit plan administration, preferably in a multi-employer environment
- 3-5 years of management experience
- Extensive knowledge of medical and hospital claims administration procedures
- Strong management skills
- Strong communication skills, both oral & written
- Superior organization skills and demonstrated ability to effectively manage multiple priorities and people at all levels of the organization
- Demonstrated leadership and judgment skills
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