Benefits Sr Consultant (Contract)

Every day, in ways both big and small, the Medical College of Wisconsin (MCW) is impacting lives for the better. MCW … changemaking for a healthier Wisconsin. In the role of Benefits Senior Consultant you will beworking in Human Resources. 

Purpose

The Benefits Sr. Consultant – Health & Welfare is responsible for managing and planning the day-to-day operations of group Health and Welfare benefits plans to include self-funded health, pharmacy, stop loss, dental, vision, flexible spending, life and disability plans. Responsibilities include overseeing claim disputes and appeals, and ensuring employee concerns are addressed by front line Benefits Staff.  The Benefits Sr. Consultant also ensures MCW plans are compliant with state and federal regulations and makes recommendations for plan changes and provides analytical support for plan performance.  The incumbent will manage MCW’s health and dental Third-Party Administrators (TPA) to ensure timely and correct payment of claims in concert with the Plan Description and our insurance brokers. The incumbent will lead and/or participate in all projects affecting benefits maintenance or changes.  Assists Benefits Team leadership with communications associated with benefit programs.

Primary Functions

• Oversees the day to day operations of the Health and Welfare benefit plans, including TPA management, employee questions, managing claims auditing process, overseeing the processing of monthly billings and payment of administrative fees.  Also audits the accuracy of data and reporting.
• Serve as the second level escalation resource for Benefit Consultant for Health and Welfare plan related questions.
• Manage Request for Proposal process for Health and Welfare vendors and participate in the selection and supervision of Third-Party Administrator, benefits consultants, brokers, and vendors along with Benefits Manager and Benefits Director.  
• In conjunction with Benefits Manager and Benefits Sr. Data Consultant, analyze and evaluate plans and services, and make data driven recommendations for improvements for the self-funded Health, Pharmacy, Stop Loss, and Dental plans to ensure we are getting the best service and value for our employees.
• In conjunction with Benefits Manager, responsible for overseeing the creation and maintenance of benefit related communications and materials for emails, intranet, mailings, etc.
• Oversee implementations and benefit programs in concert with Benefits Manager, Third-Party Administrator, and insurance broker for Health and Welfare plans.   
• Responsible for ensuring compliance with plan documents, ERISA, required notices, and any required postings or communications. 
• Consult with brokers and TPAs concerning plan operations and assist in issue resolution including plan appeals.  Works effectively to ensure plan runs smoothly.  Investigates discrepancies and provides information in non-routine situations.
• In conjunction with Benefit Consultant, manage the Annual Open enrollment process to include coordination of staff, project management with our HRIS partners, and TPAs.
• Certification: CEBS Preferred

Knowledge – Skills – Abilities

• Senior level experience with Self-Funded plan management including an understanding of claims processing, plan document compliance & review, ERISA requirements and claim resolution.
• Advanced ability to analyze plan usage, trends, and outcomes. 

• Excellent oral, written and interpersonal skills resulting in the ability to interact with all levels of management and employee population
• Proficient in all Microsoft Office products, including demonstrated ability to analyze metrics in Excel, prepare spreadsheets, and share data in an understandable format.
• Ability to handle multiple tasks simultaneously and prioritize tasks/projects based on business needs
• Project management skills
• Ability to work unsupervised in a remote setting
• High energy with the ability to drive results
• Solid influence, negotiation and facilitation skills
• Highly evolved critical thinking, problem identification and solution
• Ability to resolve ambiguous, confidential and sensitive situations
• Ability to work and communicate successfully with all levels of internal and external contacts
• Ability to communicate orally and in writing clearly and logically 
• Ability to foster and maintain solid working relationships
• Ability to effectively plan and organize projects impacting the work of others
• Knowledge of federal and state benefits laws

Education: Bachelors DegreeEmployment Type: Full Time