Senior Health Plan Pricing Analyst

TriNet•Atlanta, GA

1d•$70,800 - $132,750•Onsite

About The Position

The Senior Health Plan Pricing Analyst is responsible for multiple tasks within the department including ensuring the appropriate medical rate is assigned for a prospect. This role uses specialized tools developed by third party industry experts and TriNet's carrier partners to evaluate submitted documents and census information to determine the correct medical pricing for prospects based on the actual risk they present. In addition, their role is to assist the manager with the training of new colleagues as well as a primary liaison with carriers and the carrier pricing teams. This role will be an expert in the field of medical insurance underwriting and/or PEO health plan pricing having mastered the nuances of pricing and is a key contributor to the team.

Requirements

Bachelor's Degree or equivalent experience preferred
Typically, 5+ years in insurance pricing or underwriting required
Strong analytical and quantitative skills.
Knowledge of medical underwriting principles, health plan design, and risk assessment methodologies.
Ability to interpret complex medical and financial data.
Advanced Excel and data analysis capabilities.
Strong written and verbal communication skills.
Ability to manage multiple priorities and exercise independent judgment.
Experience with trend analysis, risk forecasting and claims evaluation
Ability to interact with Sales to explain medical pricing guidelines, requirements, etc.
Proficient in Microsoft Office Suite; specifically with Excel
Ability to handle multiple tasks and prioritize projects

Nice To Haves

Salesforce.com knowledge is preferred

Responsibilities

Evaluate employer group risk characteristics, demographic data, claims experience, and supporting documentation to determine appropriate medical pricing and underwriting decisions
Work independently to determine an appropriate medical price based on the risk of the group using multiple tools such as the parity testing tool and medical pricing tool
Analyze census data, benefit plan designs, medical rates, and underwriting information to assess risk exposure and recommend pricing actions
Review complex cases, including large groups, self-funded plans, and high-risk accounts, to ensure sound pricing decisions.
Identify trends, inconsistencies, or risk factors that may impact pricing accuracy, profitability, or plan performance
Collaborate with Revenue, Carrier Partners, and internal stakeholders to communicate pricing requirements, pricing rationale, and risk considerations.
Assist with process improvements, tool enhancements, training, and mentoring of less experienced underwriting colleagues as required
Ensure compliance with all carrier partner requirements
Assist in training of new colleagues and ongoing training of new colleagues
Performs other duties as assigned
Complies with all policies and standards