Senior Benefits Adviser

Sequel Med Tech•Manchester, NH

2d•Hybrid

About The Position

The Senior Benefits Advisor is responsible for supporting the strategy, design, optimization, and compliant administration of the organization’s benefit programs. This role is ideal for someone who is naturally curious, analytical, and driven to understand the full mechanics of benefit plan design; identifying opportunities to reduce costs through proactive, employee centric health initiatives. In partnership with internal teams and external vendors, the Senior Benefits Advisor plays a key role in maintaining fiduciary and HIPAA related safeguards for our self-funded medical plan while supporting our broader goal of becoming an employer of choice through a healthier employee population.

Requirements

Bachelor’s degree in Human Resources, Business Administration, or related field; or equivalent combination of education and experience
8+ years of experience in benefits administration, plan design, HR, insurance, or population health.
Deep knowledge of self-funded plan governance, fiduciary responsibilities, and compliance with HIPAA and other related regulatory requirements.
Strong analytical skills and intellectual curiosity, with the ability to proactively investigate plan performance, review plan documents, and analyze claims and financial data to identify trends, risks, and root causes.
Demonstrates a fiduciary mindset, with a track record of making decisions aligned with plan participants’ best interest in mind.
Customer service mindset and commitment to improving employee experience with their benefits plans.
Experience with benefit vendor management, claims data interpretation, and/or benefit plan modeling to support strategic recommendations and ongoing plan optimization.
Excellent communication and advisory skills, including the ability to translate complex benefits, compliance, and financial concepts into clear, actionable guidance for employees, leaders, and stakeholders.
Proficiency with Excel, reporting tools, HRIS platforms, and benefits administration systems.
Able and willing to work in Sequel’s Manchester, NH office 3 days per week.

Responsibilities

Analyze medical, pharmacy, and ancillary plan designs to identify cost drivers, inefficiencies, and opportunities for improved outcomes.
Recommend plan design enhancements that support preventive care, better care navigation, and improved population health while reducing plan costs.
Collaborate with brokers, carriers, and consultants on modeling plan design and cost impact scenarios.
Review claims data, disease burden trends, and utilization patterns to identify proactive cost reduction opportunities.
Convert findings into actionable strategies such as steerage programs, enhanced clinical management, or targeted communication initiatives.
Prepare dashboards and presentations that simplify complex insights for leadership and stakeholders.
Help create clear, empathetic, accessible communications to help employees understand and make the best use of their benefits.
Support open enrollment strategy, materials, and presentations.
Identify opportunities to help employees choose high value care options and avoid unnecessary costs.
Evaluate vendor performance, ensuring program design aligns with population health goals and cost management targets.
Support implementation of programs such as virtual care, chronic condition management, behavioral health initiatives, or musculoskeletal solutions.
Ensure carriers and TPAs meet service guarantees and comply with regulatory and fiduciary requirements.
Drive RFP processes to identify innovative, cost-effective vendors, brokers, and TPAs that support improved population health outcomes and reduced plan spend.
Support the organization’s fiduciary responsibilities under ERISA for our self-funded medical plan, including prudent oversight of plan administration, claims processing, and vendor actions.
Assist with preparation and documentation for fiduciary committee meetings, including reporting, decision rationales, and compliance documentation.
Monitor plan governance practices to ensure decisions are made solely in the best interest of plan participants.
Maintain HIPAA compliance across all benefit functions, including PHI handling, authorization processes, and privacy safeguards.
Coordinate required HIPAA training and support audits, breach response procedures, and documentation retention.
Partner with internal privacy teams and third-party administrators to ensure adherence to all privacy and security standards.
Ensure benefit programs comply with ERISA, HIPAA, ACA, COBRA, FMLA, and other applicable regulations.