Company :
Highmark Health
Job Description :
JOB SUMMARY
**This role is hybrid to Pittsburgh PA requiring 3 days a week in office (Tues, Wed, Thurs)
Support the director in the designing, developing, and consulting on various health & welfare benefit design strategies for the Company. This position evaluates and benchmarks assigned current programs to determine competitive posture and assists in planning and designing changes in response to the Patient Protection and Affordable Care Act (PPACA). Responsible for collaborating with Human Resource Business Partners to provide consulting and training on health & welfare benefit issues and interfaces and supports management on health and welfare benefit design and communication issues. This position also partners with HR Operations to ensure understanding of plans and compliance requirements and provides oversight of benefit plan processes.
Key Technical & Analytical Skills:
- Benefits Plan Design Expertise:
- Benchmarking Proficiency: Extensive experience in evaluating benefit programs, comparing plan designs and pricing strategies across organizations to optimize value
- Deep knowledge of health plan options: Understanding the nuances of various health plan models (e.g., EPO, HDHP), funding arrangements (e.g., self-funded), and ancillary benefits (e.g., dental, vision, life insurance, spending accounts, voluntary benefits, Tuition Reimbursement).
- Financial Acumen: Ability to analyze cost data and model the financial impact of different plan design changes.
- Compliance Expertise
- In-depth knowledge of employee benefit regulations (e.g., ACA, ERISA, COBRA, HIPAA, etc.).
- Experience managing plan compliance including Form 5500 filings, plan document preparation and audits.
- Data Analytics and Reporting:
- Proficient excel skills
- Skills in using data to drive decision-making and create comprehensive reports.
ESSENTIAL RESPONSIBILITIES
- Communicate effectively by:
- Managing customer expectations; facilitating, planning and designing presentations and meetings.
- Partnering with HRBP’s, management and executives in implementing benefit changes.
- Advising managers and executives on health & welfare design and communication issues.
- Design, develop, and consult on various health & welfare design strategies for the Company to include, but not limited to:
- Ensuring cost effectiveness
- Ensuring market competitiveness
- Determining regulatory compliance
- Maintaining consistency with the Company’s overall strategic plan and objectives.
- Planning and design changes in response to the Patient Protection and Affordable Care Act (PPACA).
- Evaluate and benchmark assigned current programs to determine competitive posture.
- Develop unique recommendations and solutions on plan revisions as well as new plans which are cost-effective and consistent with benefit trends and company objectives.
- Collaborate with legal and tax areas to track and understand new legislation and regulations to ensure plan compliance.
- Collaborate with Finance areas to monitor, control and trend analysis of benefit costs.
- Evaluate multiple forms of benefit programs during the process of due diligence and Plan integration in mergers, acquisitions and other corporate transactions.
- Collaborate with Business Partners providing consulting and strategic direction on health & welfare benefit issues.
- Recommend policy and program changes to ensure the Company’s health & welfare programs and business objectives are aligned.
- Provide communications, training and guidance on plans and compliance requirements for administration to HR Operations and the HRBP groups.
- Interface at executive levels by providing consultative advice and direction on health and welfare design and communication issues.
- Develop strategies to report, update and extract data from HRIS and other HR systems.
- Builds databases and/or utilizes complex queries and data analysis tools.
- Design systems to calculate, track and deliver benefits to employees.
- Conducting, individually or in a team environment, multiple projects of varying size and complexity.
- Completes projects and studies as assigned.
- Plans activities and establishes objectives within allotted time frames.
- Researches and analyzes information to determine the best course of action.
- Projects are generally diverse in subject matter and objective and are typically complex, large-scope, and corporate-wide.
- Other duties as assigned or requested.
EDUCATION
Required
- Bachelor’s Degree in Human Resources, Business Administration, or other related fiel
Substitution
- 6 years of relevant experience in lieu of Bachelor's degree
EXPERIENCE
Required
- 4 years experience providing health & welfare benefit planning consultation and design.
- 3 years experience in data analysis and project management
Preferred
- 4 years experience applying knowledge of state and federal laws and regulations applicable to benefits.
- Industry Experience: Previous experience working with self-funded plans and large, complex organizations (i.e. Union negotiations).
- Project Management: Ability to manage multiple projects simultaneously and meet deadlines.
LICENCES OR CERTIFICATIONS
Required
Preferred
SKILLS
- Demonstrated consultative, interpersonal, communication, influencing and presentation skills.
- Detail oriented and self-motivated professional.
- Proficient with MS Office Suite
- Advanced knowledge of ERISA, HIPAA, COBRA, ADA, IRS Section 125 & 129, and the Afforsable Care ACT (ACA)
- Advance knowledge of relative legislation and mandated compliance
Language (Other than English):
None
Travel Requirement:
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-based
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Rarely
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
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For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org
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