Consultant ( EH & B )
8 - 10 years experience • Managed Care & Health Insurance
Location: Salt Lake City, UT
Visas cannot be considered at this time
The Employee Health & Benefits (EH&B) Consultant will manage and advise client accounts for employers with 500 - 5,000 employees with their medical, dental, life and disability benefits plans and programs and will be considered the owner of the client. The level of support depends on the size of client as well as complexity and revenue of the account.
To fulfill this role, the EH&B Consultant will:
Prepare agendas and lead client/team meetings.
Lead client teams' projects and deadlines utilizing project management tools.
Ensure compliance with professional standards including use of templates, client calendar, peer review, and transparency.
Assist with developing employee communications strategy and oversee other team members in the execution of this strategy including management of open enrollment process
Responsible for engagement letter process including the confirmation of our specific scope of services, compensation type and level, project timeframe and required data
Accountable for revenue/profitability for client accounts
Responsible for establishing necessary carrier/vendor relationships with appropriate contacts to serve clients in handling all administration of eligibility, claims, billing, plan implementation, contracts, plan changes and necessary amendments
Resolve client issues via phone or email. May delegate issue to the analyst and if the analyst cannot resolve the issue, the consultant will then contact carriers and vendors on behalf of the client to resolve these issues
Work directly with the client and manage the request for proposal (RFP) process with the health insurance carriers and internal analyst.
Review the analyst's compilation of the health benefits information from a variety of sources (such as hard files, electronic files, the client and carriers), responses from the carriers and the data in a spreadsheet template (customization depends on client plan types, funding, rate structure, etc.), reviews the transparency documents (compliance documents required for completion of all health and benefits work); maintain all appropriate documents in proper files
Peer review RFP information, analyze and interpret the results, edit and finalize the executive summary report to be sent to the client
Review claim and utilization data from insurance carriers on a monthly/quarterly basis that has been input into a standardized reporttemplate by the analyst; analyze and interpret data for trends; peer reviews customized, client ready reports; submit report to client and replies to any questions the client may have
Reviews summary plan description (SPD), plan documents and 5500s for compliance and compare to the benefits that were sold to the client. Ensures all benefits are accurately reflected, following a checklist to ensure that all necessary information is included where appropriate. Follows up with the carriers to make sure necessary changes are reflected.
Generate new sales through existing clients and client referrals in accordance with the sales plan.
Qualifications and Experience:
BA/BS degree is preferred
Minimum seven years health benefit experiencerequired
Strong analytical and mathematical skills; strong command of Excel
Understanding of health benefits underwriting concepts
Excellent interpersonal skills; strong oral and written communication skills
Ability to prioritize and handle multiple tasks in a demanding work environment
Ability to work independently and on a team.
State Life Accident & Health License must be obtained within three months of hire date