Health & Benefits Job Description
Health & Benefits Duties & Responsibilities
To write an effective health & benefits job description, begin by listing detailed duties, responsibilities and expectations. We have included health & benefits job description templates that you can modify and use.
Sample responsibilities for this position include:
Health & Benefits Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Health & Benefits
List any licenses or certifications required by the position: CEBS, SPHR, PHR, FAIS, FPC, CPP, CDMP, ASA, CPR, GBA
Education for Health & Benefits
Typically a job would require a certain level of education.
Employers hiring for the health & benefits job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Collage Degree in Business, Education, Associates, Finance, Mathematics, Human Resources, Actuarial Science, Statistics, Business/Administration, Department of Education
Skills for Health & Benefits
Desired skills for health & benefits include:
Desired experience for health & benefits includes:
Health & Benefits Examples
Health & Benefits Job Description
- Acts as a single point of contact for plans under purview and projects
- Marketing efforts – gather benchmarking, utilization or rate data from the vendors via a Request for Proposal (RFP)
- Tracking claims experience – gather data from client and vendors and check for reasonableness using independent judgment
- Plan design consolidation – gather data from the client and current vendors needed for analyzing the impact of a client’s consolidation of its healthcare plans
- Outbound calls/messages for issue resolution and follow-up
- Assist employees and managers with Employee Self Service (ESS) and Manager Self Service (MSS) transactions
- Transactional Processing
- Manage ticketing system inquiries
- Provide exceptional customer service to office HR, vendors and all personnel, answering benefit questions in a timely manner and resolving problems related to payment of benefits, benefit plan eligibility and enrollment Help administering the medical plans
- Maintain knowledge of government regulations, , HIPAA, ERISA, IRS, DOL, Section 125, GINA
- Minimum of 2 years of relevant work experience within the Health and Benefits industry or in an analytical supportive role
- Manage project(s) to ensure deliverables are met on time with high quality and within approved budget
- Coordinate project activities and deliveries across different service providers (broking, health care, technology) and different application platforms
- Monitor and evaluate team activities, assess and document performance including identifying of problems associated with the project, providing appropriate resolution and implementation
- Develop and Implement a project plan which includes developing and gathering of resources, determining team members, assigning tasks, developing timelines and establishing scope of responsibilities
- Develop progress reports for the clients and team members to assess or quantify the status of project
Health & Benefits Job Description
- Maintain records and procedures for benefit administration processes
- Assumes primary responsibility, through staff and working closely with City financial departments, for all health insurance related financial management
- Maintains a strong understanding of federal and state laws that govern the provision of health insurance to municipal employees including M.G.L
- Hires and manages various contractors in accordance with M.G.L
- Assesses situations and derives potential resolutions to a diverse range of complex problems, using analytics and solid judgment, and by organizing/validating a variety of observations or issues in a fact-based, detail-oriented manner
- Assess current health care programs, market and market trends, legislative, tax and social changes that impact current programs
- Analyze and review health benefit and social programs within each country and recommend changes and enhancements as necessary to ensure the programs are efficient, market competitive, compliant with local tax laws
- Conduct/validate benchmarking analyzes by country and region and for competitive/peer groups
- Design and develop templates, decision matrix and processes so programs are assessed and evaluated on a consistent basis throughout the world
- Assist in the development of reporting metrics and benchmarking regarding current plan performance and costs, including risks and opportunities
- Support Mercer Marketplace pharmacy projects including product review, financial assessments, implementations, plan design analyses and financial projections, pharmacy renewals, benchmarking, pharmacy benefit marketing and diagnostic reports, vendor and performance management
- Prepare client ready deliverables for senior peer review and present to clients
- Interact with members of the Mercer Marketplace and Managed Pharmacy Practice (MPP) client teams
- Superior analytical and mathematical skills
- One to three years of industry or relevant underwriting experience required
- Proven experience successfully managing multiple projects simultaneously and producing quality deliverables on time and within budget
Health & Benefits Job Description
- Monitor overall health benefit programs in regards to adherence to internal policies and external legislation including compliance of all regional
- Develop tools, training and coaching with the Regional Total Rewards Leaders for country Human Resource Leaders in regards to ongoing benefits management
- Establish Policies and Procedures for Global Health Programs
- Negotiates coverage, services, and costs with partners
- Assists with benefits communications (enrollment materials, SPDs, brochures, guides, online materials, videos, presentations)
- Research, analyze, and resolve benefit issues or inquiries escalated by employees
- Work with health benefits vendors to administer, and resolve co-payments, claim submission issues
- Create and submit reports on relevant benefits metrics including eligibility and claims
- Advise employees and/or HR as needed in handling complex transactions related to benefits
- Provide audit support to ensure accurate enrollments and contributions
- Understand more advanced underwriting and financial skills, Health & Benefit products, services and technical tools, and intranet resources by participating in training courses, online learning, or through learning from more experienced colleagues
- Required to obtain and maintain appropriate licenses as required by regulations and Mercer policies
- Performs competitive and cost analyses (qualitative and quantitative), modeling plan design scenarios and conducting relevant statistical analyses in support of plan design and decision making
- Obtain market insights/trends, interprets results and makes recommendation to Total Rewards leaders
- Provide analytical and executional support of various rewards related activities, including overseeing content management of related global sites, if applicable, leveraging the Service Center or local HR resources
- Works with vendors in the delivery of related activities
Health & Benefits Job Description
- Support open enrollment processes
- Administers various employee benefit programs, such as group insurance
- Prepares and ensures accuracy of timely allocation, calculation and the remittance of vendor payments and insurance premiums
- Performs periodic system audits and participates in annual audit process
- Assists with the development, coordination and delivery of employee communications
- Maintains statistical data including premiums, employer and employee contributions, claims and costs
- Resolves issues with carrier representatives, vendors and others
- Responds to escalated inquiries and service needs to ensure quick, equitable and courteous resolution
- Supports ongoing and special benefit projects to include, but not limited to, annual enrollment, leave of absence administration, health and wellness initiatives, systems software testing and implementation, benefit education and system and service enhancements
- Assist employees/HR in completion of forms and provide general response to benefit inquiries Assist in the roll-out and administration of health and wellness initiatives
- Provides expertise to deliver rewards related matters and projects
- Supports Total Rewards management in the coordination of project, process or activities and oversees the proper and compliant administration of benefits plans and programs
- Support of mergers, acquisitions and divestiture activities, including side-by-side Rewards program comparisons and implementation of transition activities and make recommendations, as appropriate
- Takes a lead role to ensure the timely completion of various COE short-term projects
- Develops & executes rewards related training activities for HR and associates
- A Bachelor degree in or a related field or equivalent required
Health & Benefits Job Description
- Draft Policies and Procedures for Global Health Programs
- Support assessment of current health programs, market and market trends, legislative, tax and social changes that impact current programs
- Analysis of employee demographics
- Analysis of the epidemiological profile of the population (if such data is available)
- Analyze existing benefits of clients so to populate reporting templates and prepare side-by-side benchmark analysis
- Check and analyze benefit utilization/experience data
- Prepare and analyze reports on utilization experience and analysis, calculation of loss ratios, IBNR’s, frequency of the use, member profile, high level benefit costing
- Analyze available funding options
- Analysis of the advantages and disadvantages of the plan funding model (insured or self-insured)
- Assist in designing and costing alternative plans to suit client needs
- 3+ years Health & Welfare Benefits experience in implementation and administration in a large, complex organization (Fortune 500 experience preferred)
- Ability to work independently and quickly assess and resolve issues, while translating complex information into understandable terms
- Self-starter with demonstrated ability to lead, prioritize and handle multiple tasks and projects simultaneously
- Demonstrated ability to effectively present information
- Advanced knowledge of regulatory and compliance environment and applicable laws affecting rewards plans in the region
- Strong qualitative, analytical and project management skills