Job Description SummaryJob DescriptionThis position is eligible for remote work anywhere within the United States. However, candidates who reside within a commutable distance to our corporate headquarters in Saint Petersburg, FL (including the Tampa Bay area) will follow a hybrid work schedule, typically requiring 3 days per week in the office.
As a Senior Advisor, Health & Wellness, you leverage deep expertise developed through experience to lead and support health care data analytics, manage health insurance-related escalations, and oversee benefit compliance activities, along with other related benefits programs. You operate with a high degree of autonomy while following established processes to execute both routine and complex work, exercising sound judgment and decision-making responsibility.
You serve as a subject matter expert across a range of issues, from basic to complex, and determine when to escalate or engage senior leadership or external benefit consultants. This role requires extensive interaction with internal stakeholders, insurance carriers, and third-party administrators to identify, research, and resolve issues related to benefit coverage, leaves of absence, and payroll deductions.
Essential Duties and Responsibilities- Analyzes aggregate health and welfare plan data to inform recommendations related to trends and plan design changes
- Serves as central point of contract for escalations related to associate issues on insurance related issues with carriers
- Is the primary SME on benefit compliance subject issues including HIPAA, ACA reporting, and 5500s.
- Serves as a contact for internal customers, insurance vendors and/or third party administrators.
- Reviews documents and benefit changes to ensure both are in line with IRS compliance guidelines.
- Investigates and resolves moderate to complex associate complaints, issues and concerns regarding benefit programs and leave of absence by using various systems and sources.
- Communicates and ensures understanding of IRS regulations, Family Medical Leave, Health Savings Account regulations and Health Care Reform questions by managers, associates and potential candidates as needed.
- Properly manage the communication and resolution between associate and benefit plan vendors on unique issues (e.g. eligibility, claims, and general adherence to plan provisions)
- LOA administration and compliance - Liaison between vendor, associates, managers, HR COE's to ensure compliance and resolve unique issues.
- Manage the associate transition from leave of absence to potential job accommodation or long-term disability status.
- Investigates, audits and resolves differences with associate vacation and sick accrual accounts.
- HRMS system processing for vacation/sick entitlements, enrollment changes, leave of absences, payroll deductions and audits.
- Participates in the RFP process and assists with managing vendor benefit plan implementations.
- Responsible for the managing all compliance issues, audits and payments to applicable state programs
- Manages the open enrollment process for associates on a leave of absence.
- Audits open enrollment data files and carrier file exception reports to determine action needed to correct data errors reported that impact enrollment records.
- Maintains current knowledge of legal requirements as well as state and federal regulations which impact benefit administration functions and ensures compliance .
- RJNet content reviewer/editor
- Liaison between Corporate Communications and Health and Wellness Services to promote ongoing initiatives.
- Responsible for reviewing all documents for family status changes to ensure compliance with IRS regulations
- Prepares and delivers written and oral presentations to internal customers.
- Manage and increase utilization of onsite health clinic
- Coordinate New Hire benefit enrollment process.
- Other duties as assigned.
Knowledge of- Proven ability to organize, analyze, and utilize complex data related health care/vendors related data to inform recommendations
- Advanced knowledge of benefit related laws including ERISA, ACA, COBRA, and IRS requirements.
- Proven record of taking on new/additional responsibilities and assisting the team in completing whatever work is available.
- Company's working structure, policies, mission and strategies.
- Federal and state legislation, including Family Medical Leave, State specific paid leaves, San Francisco City Option, San Francisco Commuter and Health Care Reform.
- Advanced HRMS System processing and report analysis.
- Principles, practices and procedures required for managing the administration of assigned insurance plans or programs.
- Expertise with various health and wellness plan designs and annual enrollment.
Skill in- Investigating discrepancies.
- Gathering data, processing billings and preparing payment for approval.
- Preparing and delivering presentations to internal customers.
- Operating standard office equipment and using required software applications to produce correspondence, reports, electronic communication, spreadsheets and databases.
- HRMS processing, audits and queries, strongly preferred.
- Knowledge of ERISA plans preferred.
- Proficient in Microsoft Excel- ability to perform and create various functions and reporting
- Intermediate Excel skills preferred.
- Report writing skills, including PeopleSoft Query, PeopleTools, and SQL strongly preferred.
- HIPPA certified /compliance training completed
Ability to- Partner with other functional areas and senior leaders to accomplish objectives.
- Interpret and apply state and federal regulations and applicable rules to complex benefit and leave of absence issues and problems.
- Read, interpret, analyze and apply information from insurance related materials and service agreement contracts.
- Organize, manage, and track multiple detailed tasks and assignments with frequently changing priorities and deadlines in a fast-paced work environment.
- Communicate effectively, both orally and in writing.
- Work independently as well as collaboratively within a team environment.
- Keep all appropriate parties up-to-date on decisions, changes and other relevant information.
- Articulate reasons behind decisions.
- Provide a high level of customer service.
- Maintain strict confidentiality.
- Maintain currency in all aspects of assigned insurance area.
- Establish and maintain effective working relationships at all levels of the organization.
- Proven ability to listen to clients, identify their specific concerns, and resolve them strongly preferred.
- Proven ability to respond with courtesy and professionalism to difficult clients preferred.
- Ability to resolve client calls with a minimum of escalation preferred.
Education/Previous Experience- College Degree equivalent and a minimum of five (5) years of related experience.
- Call center experience requiring problem resolution a plus.
- Five years' experience in health and welfare group insurance and leave of absence strongly preferred.~or~
- Any equivalent combination of experience, education, and/or training approved by Human Resources.
Licenses/Certifications- CEBS or CBP a plus.
- PHR/SHRM certification/ Continued Education in Insurance Area
EducationBachelor's: Business Administration, High School (HS) (Required)
Work ExperienceGeneral Experience - 3 to 6 years
CertificationsSalary Range$75,000.00-$95,000.00
TravelLess than 25%
WorkstyleRemote
The total compensation for this position includes base salary or wages, and may include components such as additional compensation (cash or equity), discretionary bonuses, or commissions. This position is eligible for a benefits package that may include medical, dental, and vision; life insurance; critical illness insurance and accident insurance; disability benefits; retirement savings; paid time off (including vacation, holidays, and sick leave); and parental leave. Eligibility for benefits and specific offerings may vary based on position and employment status. To view more details of the benefits offered, visit Myrjbenefits.com.
