Job description
Overview:
Qualifications:
Administer all aspects of the benefit functions for ArchCare. Develop and maintain Benefit practices that provide a high level of service throughout the system. Provide a central point of leadership, knowledge, and advice. Evaluate benefit practices; recommend changes in plan design, and formulate overall benefit strategy. Continually monitor all benefit activities; claims administration; and effectiveness of benefit services. Develop and maintain an effective working relationship with business partners to ensure the highest level of customer service, and prompt action to resolve Benefit related issues.
Responsibilities:
- Direct the planning, implementation, and communication of all employee benefit programs; Work closely with brokers, vendors, and staff to ensure successful communication and implementation of benefit programs. Oversee new hire benefit enrollments, terminations, changes in status, etc.
- Identify benefit related challenges and opportunities; develop solutions and strategies to resolve issues and capitalize on opportunities.
- Manage day-to-day relationships with external partners including actuaries, consultants, and plan administrators to ensure compliance with plan documents and legal requirements.
- Routinely audit plan participation and claims; ensure appropriate enrollments through census review, dependent verification, etc.
- Review all insurance payables and billing statements to verify participants and authorize payments
- Coordinate with payroll and compensation to ensure the proper administration of employee contributions and other benefit issues such as accruals, etc.
- Direct the administration of employee leaves of absence including FMLA.
- Plan, develop, and participate in area and industry surveys.
- Analyze results of surveys and develop specific recommendations for review by senior management.
- Develop census data and solicit insurance quotations, as necessary.
- Maintain superior customer service to all internal and external customers; Establish trust with all constituents by being a resource that is dependable and provide useful counsel in solving problems pertaining to Benefits.
- Maintain professional and technical knowledge by attending educational workshops; review professional publications; establish personal networks; participate in professional societies.
- Ensure optimal customer service for handling benefit inquiries/complaints to ensure quick, equitable, courteous resolution and maintain contact with participants, providers, TPA's, and beneficiaries to resolve matters with appropriate sensitivity to privacy issues.
Education Requirements
- Bachelor's Degree
Education Desired
- Master’s degree or a combination of education and experience meeting minimum requirements preferred.
Experience Requirements
- A minimum of 5 to 10 years experience administering benefits in a union and non-union environment, including applicable billing and contribution methodologies.
- Experience working closely with benefit providers, actuaries, and brokers to ensure effective coordination of benefit processes.
- Experience in a high level HR position at a large health care facility or a multi-divisional health care system strongly preferred.
- Experience resolving complex claim issues. Ability to work independently, with a strong attention to detail.
Skill Requirements
- Must have well-developed management and administrative skills.
- High level of mathematical and analytical ability required, as well as advanced skill in information systems.
- Ability to organize complex information in a clear and concise manner.
- Detailed knowledge of standard employee benefit plans, including medical, dental, life, disability, worker’s compensation, vision, flexible spending, pension, and deferred compensation.
- Exceptional interpersonal and intuitive skills, with the ability to listen beyond words.
- Effective leader, with the ability to foster an integrated team approach.
- Proven ability to maintain the highest level of confidentiality.
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