Senior Consultant - Employee Benefits

Relation Insurance Services•Sacramento, CA

3d•$68,000 - $138,000

About The Position

The Senior Consultant serves as the primary business contact for the client and is responsible for client satisfaction. The person in this position is expected to consistently provide excellent customer service to accounts, as well as represent client needs and goals within the organization to ensure legendary service delivery. In addition, the Senior Consultant will build relationships with clients to encourage new and repeat business opportunities. The Senior Consultant is accountable for revenue/profitability for client accounts and responsible for managing at least $1 million in revenue.

Requirements

A Life Accident & Health License from state of domicile is required and must be maintained.
High School Diploma or equivalent required.
Minimum 7 years’ account management experience in the insurance industry with a focus on Accident and Health lines of coverage is required.
Exceptional understanding of the lines of coverage for employee benefit plans: medical, dental, life, long-term disability (LTD), short-term disability (STD), accidental death and dismemberment (AD&D), vision, etc.
Exceptional knowledge of the rules and regulations associated with HIPAA, COBRA, Health Care Reform and all other legislation and compliance related areas to Group Health programs.
Exceptional knowledge of insurance markets, products, services, insurance ratings and underwriting procedures.
(California-Only) In-depth understanding of AB1672 and Small group regulations.
(California-Only) Required to participate in the process of identifying and selecting General Agents.
Must have knowledge of the services that California General Agents provide and be able to utilize General Agents to the maximum capacity.
Must understand R.A.F. (Risk Adjustment Factor) and the components to how rates are created, maintained and delivered on new business and renewals.
Outstanding interpersonal and communications skills are required to maintain effective relationships with clients, co-workers, carriers, vendors and others.
Advanced skills in Microsoft Office (primarily Excel, PowerPoint and Word).
Must be computer literate with the ability to learn new software applications, such as online benefit enrollment programs and carrier enrollment sites.
Ability to work independently with limited daily supervision and to work effectively in a team environment.
Must have a valid driver’s license, the ability to travel to client sites and a reliable source of transportation.

Nice To Haves

Advanced professional designation highly desirable (e.g. CEBS, CBP, etc.).
Four-year degree preferred.

Responsibilities

Leads client teams' projects, deadlines and meetings utilizing project management tools.
Ensures compliance with professional standards including use of templates, client calendar and peer review process.
Develops employee communications strategy and oversees other team members in the execution of this strategy including management of open enrollment process.
Responsible for establishing necessary carrier/vendor relationships with appropriate contacts to serve clients in handling all administration of eligibility, claims, billing, plan implementation, contracts, plan changes and necessary amendments.
Works directly with the client and manages the request for proposal (RFP) process with the health insurance carriers and internal underwriter and account managers.
Reviews the underwriter and/or account manager’s compilation of the health benefits information from a variety of sources responses from the carriers and provided data, reviews the transparency documents and maintains all appropriate documents in proper files.
Peer reviews RFP information, analyzes and interprets the results, edits and finalizes the executive summary report to be sent to the client.
Reviews claim and utilization data from insurance carriers on a consistent basis, analyzes and interprets data for trends, peer reviews customized reports, and submits reports to client, responding to questions as appropriate.
Creates client presentations using Excel and PowerPoint to summarize client data obtained from vendors or Relation consultants.
Develops benchmarking reports by gathering health benefits data to compare a client's plan information) to other companies by industry or geography and provides the information to the client.
Gathers necessary data from the vendor or client; reviews to ensure it is complete, accurate, and reasonable.
Values medical, dental and prescription drug plan designs by entering plan design information to develop the relative cost differences between plan designs, in order to compare the client's current plan to alternative designs.
Develops employee contributions scenarios by entering current employee medical contribution data into an Excel spreadsheet and projecting contributions to the next plan year, taking into account the cost-sharing goals of the client.
Reviews external vendor contracts, summary plan documents and employee communications to ensure alignment with client expectations and legal requirements.
Reviews Summary Plan Descriptions (SPD) from the carrier and compares it to the client's benefits for accuracy.
Understands and demonstrates project management and consulting skills.
Develops employee communication materials such as benefit brochures, open enrollment presentations, employee memos, etc.
Recommends process improvements as needed.
Fully adopts innovative technology, including proprietary AI solutions, into the service process to deliver a best-in-class client service experience.
Performs other projects, duties, and tasks, as assigned.