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Company

Harbor HealthSee more

addressAddressAustin, TX
type Form of workFull-Time
CategoryInformation Technology

Job description

Job Description

Harbor Health is looking for an experienced Health Plan Benefit Design Lead to become a member of our team! Harbor Health is an entirely new multi-specialty clinic group in Austin, TX utilizing a modern approach to co-create health with those who get, give, and pay for it, allowing everyone to fully flourish. Join us as we build a fully integrated system that connects care to a better payment model that truly puts the human being at the center.

The Health Plan Benefit Design Lead will be responsible for the development, analysis and application of advanced and complex benefit design for health plan offerings.

Our Health Plan Benefit Design Lead will be responsible for:

  • Design, develop, analyze, and implement benefit plans with a high degree of accuracy
  • Work in benchmarking and evaluation of potential initiatives relative to benefit plan design, including running financial models and performing related analyses in conjunction with benefit consultants, vendors, and other partners
  • Gather and analyze member data and requirements, assess the benefit impact of current design
  • Partner with various teams, including the Actuarial, Clinical and Sales team, to analyze member specific requirements and configuration and translate those into technical design specifications and data flow from which programs are developed and coded
  • Partners with internal teams, vendors and others on the implementation of new plans, plan design changes,  including review and updating technical requirements to support Open Enrollment and other ad hoc projects
  • Develop and provide detailed metrics and analysis on targeted benefit programs to evaluate costs and competitiveness, identify trends and risks, ensure legislative compliance, determine and recommend appropriate strategic plan design changes and/or mitigation strategies
  • Participate in and lead internal calls with external partners to understand the intent of requested benefit changes
  • Identify, analyze, and present to Leadership creative solutions for process improvement activities regarding benefit configuration
  • Coordinates responses to both external and internal audits. Ensures workflows support compliance and identifies when audit protocols need to be refreshed to more accurately capture day-to-day procedures
  • Evaluate audit findings and implement new processes to bring benefit configuration into compliance
  • Maintain awareness and understanding of new and existing laws, regulations and guidance applicable to health and wellness benefit plans, including ACA, ERISA, HIPAA, Section 125, HSA, and COBRA

Successful Health Plan Benefit Design Leads will have:

  • Bachelor’s Degree in Business, Human Resources, Actuarial Science, Healthcare Management, Economics or related field
  • Benefit design experience in an Insurer or Human Resources capacity
  • Advanced experience in Microsoft Excel, PowerPoint, and other business tools in the analysis, preparation, and presentation of plan information, data, and metrics

Additional Skills & Experiences Preferred include:

  • Master’s degree in Human Resources, Business or related field
  • CBP or CEBS certification

Physical Requirements of the role include:

  • Travel up to 25% of the time

If you are passionate about health care and you want to create something new together, we want you to be a part of our team!

 

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Refer code: 3338757. Harbor Health - The previous day - 2023-03-23 16:06

Harbor Health

Austin, TX
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