Health Benefit Plan Review

NTT Data (Confidential Company) Braintree , MA 02184

Posted 6 months ago

NTT Data Services is assisting a health care client with the recruiting efforts for this position. This is not a position with NTT DATA.
Full time
Direct Hire Position

The Plan Drafter is required to draft, edit, analyze and review health plan documents and plan amendments and other healthcare materials for clients, and as required by evolving laws and regulations, communicate with clients regarding compliance and other specified issues and solutions.

Key Responsibilities

• Prepare new and/or restate existing health plan documents, plan amendments and other plan materials for self-funded employer groups. A non-exhaustive list of documents required to be produced on behalf of clients includes the following: major medical, prescription, dental, vision, disability, cafeteria, health reimbursement arrangements, and summary of benefits and coverage (SBC).

• Craft comprehensive client communications analyzing health plan documents, plan amendments and other plan materials for self-funded employer groups to (1) identify and resolve any compliance issues; (2) eliminate any inconsistencies; and (3) cohesively outline recommendations and modifications.

• Act as a facilitator to communicate (internally and with external clients) to resolve any plan or benefit questions generated which relate to the produced health plan documents, plan amendments and other plan materials.

• Collaborate with appropriate team members to build context to ensure any compliance issues, inconsistencies and/or plan modifications are comprehensively documented and easily understood.

• Ensure documents are completed accurately, timely and in compliance with all regulatory requirements (i.e. ERISA, COBRA, ACA, HIPAA, and other applicable federal and state laws) and are tailored to specifically meet the needs of clients.

• Remain current and versed on all evolving and applicable state and federal laws to accurately identify risks or concerns with client health plan documents, plan amendments or other plan materials.

• Directly communicate with clients on plan design options, including consultative design phone calls with plan sponsors, brokers, third party administrators, stop loss carriers and other related entities.

• Act as a liaison between the company and external clients in an effort to proactively finalize outstanding projects and plan materials.

• Independently arrange and host conference calls with clients regarding compliance and regulatory issues.

• Review and research federal and state law compliance and cost containment issues and remain current on all regulatory changes and updates.

• Acknowledge and timely address and respond to all internal and external client projects, with ability to accurately escalate concerns.

• Produce high-quality work product which aligns to relevant company best practices, procedures and policies.

• Perform other duties as requested or required.

Experience and Qualifications

• Bachelor’s Degree or equivalent combination of education and experience preferred.

• Strong attention to detail is required.

• Excellent time management and prioritization skills.

• Ability to meet strict deadlines and/or expedite projects to meet the needs of a client.

• High degree of organizational skills.

• Possess working knowledge of ERISA, ACA and other employee benefit regulations.

• Ability to provide consultative feedback related to the creation and preparation of plan materials.

• Ability to listen and communicate (written and verbal) with all levels of staff, vendors and clients.

• Proficiency with Microsoft Office Word, Excel and Outlook applications.

• Work independently with ability to multi-task and prioritize project load in order to meet deadlines.

• Excellent interpersonal/relationship-building skills and ability to collaborate with and positively influence others.

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Health Benefit Plan Review

NTT Data (Confidential Company)