Sr. Account Manager, Employee Benefits

Job Type

Full-time

Position Summary:

Senior Account Managers serve as the day-to-day service lead for a book of Employee Benefit clients that is primarily self-funded, with some fully insured groups. This involves working both individually and as a team to provide proactive plan strategy, accurate financial reporting and rate projections, on time renewals, and to act as an extension of the client's Human Resource Department. In this role you will bring advanced knowledge of self-funded plan administration and alternative funding arrangements, including stop-loss, group and agency captives, level-funded plans, and carved-out pharmacy benefit manager (PBM) contracts, as well as medical, dental, vision, life, disability, and flexible spending account benefits. You will be responsible for applying pertinent federal and state regulations and compliance requirements affecting employee benefit programs (ERISA, COBRA, FMLA, ADA, ACA, HIPAA, MHPAEA, Consolidated Appropriations Act, SECTION 125, Workers Compensation, Medicare, etc.).

Here's what you'll do:

• Serves as the primary service contact for an assigned book of primarily self-funded and some fully insured clients, as well as a backup to other account managers.
• Supports team members, including Producers, Client Success Managers, other Account Managers and Account Coordinator in servicing and providing support for clients.
• Provides direction and mentorship to Account Managers and Account Coordinators, including review of renewal, reporting, and funding work product.
• Assists the Producer with developing and executing multi-year benefit strategies for self-funded clients, including evaluation of funding arrangements (fully insured, level-funded, self-funded, and captive), plan design, vendor mix, and cost containment opportunities.
• Assists the Producer with managing complex funding arrangements, including group and agency captive programs, specific and aggregate stop-loss coverage, and carved-out pharmacy benefit manager (PBM) contracts.
• Assists the Producer with preparing rate projections and renewal forecasts for self-funded clients, including claims trend analysis, funding rate and budget development, COBRA rate calculations, employee contribution modeling, and stop-loss renewal evaluation.
• Assists the Producer with producing and presenting ongoing financial reporting for self-funded clients, including claims experience, large claimant review, fixed and variable cost tracking, and stop-loss reimbursement monitoring.
• Assists the Producer with reviewing PBM contract terms, pricing guarantees, rebate arrangements, and performance reporting, and with PBM marketing and contract renewals.
• Assists the Producer with reviewing stop-loss contracts for risks such as lasers, contract basis terms, and gaps between plan documents and stop-loss coverage, and with advising clients on mitigation.
• Coordinates with third-party administrators (TPAs), stop-loss carriers, captive managers, PBMs, and point solution vendors to resolve service, claims, and contract issues.
• Prepares advanced Excel analyses and Word documents for financial reporting, plan renewals, funding analysis, and employee materials.
• Leads the preparation and delivery of client strategy, renewal, and financial review presentations in partnership with the Producer and Client Success Manager.
• Markets and negotiates new business and renewal proposals with insurance carriers, stop-loss carriers, TPAs, and PBMs by initiating and following up on requests for proposals and quotes.
• Ensures proper carrier and vendor implementation for new product lines, funding changes, and vendor transitions.
• Maintains required data in the agency management system for employee enrollment management, policy tracking, reporting, and commissions.
• Designs, builds, and maintains client online enrollment system, benefit guides and enrollment forms.
• Participates in capabilities presentations with prospective clients, contributing self-funded and alternative funding expertise.
• Participates in employee open enrollment meetings, as deemed necessary due to producers scheduling constraints.
• Assists clients with claims resolution, including escalated claims, appeals, and stop-loss reimbursement issues.
• Produces and distributes compliance documents and supports self-funded compliance requirements, including plan documents and SPDs, PCORI fees, Form 5500 coordination, and nondiscrimination testing.
• Provides HR support and advises on policy questions, claims questions, FMLA/COBRA/Disability questions.
• Any other duties and tasks that are required by the Company.

Here's what you'll need:

• Bachelor's degree preferred.
• Five (5) or more years' experience working as a Benefits Account Manager servicing self-funded clients.
• Demonstrated experience with complex funding arrangements, including captives, stop-loss, level-funded plans, and carved-out PBM arrangements.
• Demonstrated ability to build and explain rate projections, funding rates, renewal forecasts, and claims experience reporting.
• Working knowledge of self-funded compliance requirements, including ERISA, HIPAA, MHPAEA, the Consolidated Appropriations Act, PCORI, and Section 105(h).
• Advanced proficiency in Microsoft Excel, including formulas, pivot tables, and financial modeling.
• Current license in Health and Life required.
• Ability to work onsite in a full-time or hybrid capacity (management discretion).
• Excellent interpersonal skills. Warm, approachable, savvy, and empathetic.
• Extremely strong oral and written communication skills, including the ability to translate "technical speak" in a way that end users at all levels can understand.
• High energy work ethic with ability to work independently while maintaining excellent customer relationships.
• Ability to work collaboratively with others.
• Demonstrated ability to mentor and develop Account Managers and Account Coordinators.
• Ability to work without direct supervision.

Core Competencies:

• Accuracy: Achievement of correct and precise work.
• Accountability: Acceptance of responsibility and one's own actions.
• Written Communication: Ability to write letters, reports, articles, and e-mails using clear and concise vocabulary, style, grammar, and punctuation.
• Customer Orientation: A desire to serve clients by focusing efforts on listening and responding effectively to customer questions, resolving customer problems to their satisfaction, and evaluating customer satisfaction.
• Problem Solving: Ability to recognize courses of action which can be taken to handle problems or potential problems, and applying contingency plans to solve those problems.
• Analytical: Ability to gather raw data and process that data into meaningful form using a more scientific approach.
• Financial Aptitude: Ability to understand and explain economic and accounting information, prepare and manage budgets, and make sound long-term investment decisions.
• Strategic Planner: Ability to offer advice and create a plan based on analysis of issues and trends, develop a vision for the future, and create a culture in which the long range goals can be achieved.
• Coaching and Development: Ability to provide honest and timely guidance and feedback to help others strengthen specific skill areas needed to accomplish a task or solve a problem.

Work Environment & Physical Requirements:

The work environment and physical demands described here are representative of those that may be encountered and must be met by an associate to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

• Low to Moderate noise (i.e. business office with computers, phone, and printers)
• Ability to work in a confined area.
• Ability to sit at a desk for an extended period.
• While performing the duties of this job, the employee may be regularly required to stand, sit, talk, hear, reach, stoop, kneel, and use hands and fingers to operate a computer, telephone and keyboard.
• Specific vision abilities required by this job include close vision requirements due to computer work and the ability to read and understand written word.
• Light to moderate lifting may be required.