Benefits Development Specialist I

Company: Apex Systems ( Learn More )

General Information
4 Year Degree
Not Specified
Not Specified
Job Description


Assist in the analysis, development, implementation and monitoring of new and existing benefits in order to ensure benefit offerings are compliant with state and federal regulations, competitive and efficient to administer.

Minimum Job Qualifications and Technical Competencies

  • BS/BA degree in business, health care or related field and three years experience in benefit administration, project coordination, OR the equivalent combination of education and experience.
  • Ability to organize and manage time to effectively prioritize the workload and adapt to shifting priorities.
  • Ability to think analytically, apply analytical techniques, obtain benefit information from a variety of internal and external sources and provide in-depth analysis and recommendations for corrective or performance enhancing benefit strategies.
  • Experience in report preparation, project documentation, or policy and procedure writing, including the ability to organize and review statistical data and write concise relevant communications.
  • Ability to communicate effectively, with tact, orally and in writing. Demonstrated writing and editing skills. Strong presentation skills desired.
  • Demonstrated understanding (or ability to learn) about health care products, benefits and market dynamics.
  • Strong team player, ability to work within a team atmosphere to achieve department goals and objectives and thrive in a fast-paced environment.
  • Experience working with PC’s and a variety of software packages including word processing, spreadsheets and presentations.

  • Audits benefit contracts and makes recommendations based on regulations and product/benefit design changes.
  • Works with Product Development and Management, Customer Marketing, Sales, Actuarial, Marketing Communications, Business Intelligence, and other internal departments to implement, communicate and monitor all activity affecting benefits design.
  • Works with Implementation Manager to coordinate, communicate and interact with all levels of personnel to ensure effective implementation and administration of benefit development and management activities.
  • Works with, and develops relationships with external associates (e.g., regulators, legislators, lobbyists, other insurers/health plans, trade associations, etc.).
  • Represents the department and division in cross-functional activities that impact department operations (i.e. governmental and regulatory changes).
  • Analyzes interdepartmental procedures and their impact on benefit structure; makes recommendations for enhancements and increased efficiencies as appropriate.
  • Supports Product Platform Team with research and analysis as required for benefit change proposals.
  • Analyzes benefit change proposals and recommendations to ensure compliance with state and federal laws surrounding benefit coverage.
  • Tracks, reviews and analyzes regulations which can impact benefit design and presents final regulations to Product Platform Team for final recommendations. Provide feedback and analysis on proposed legislation affecting benefit design to Public Policy and management
  • Prepares and conducts benefit presentations and training to internal and external audiences.
  • Prepares benefit design summary information for internal handoff to departments for development of marketing collateral, automated customer summaries and other customer facing materials. Reviews final materials for benefit accuracy signoff.
  • Compiles competitor product/benefit information and provides information to internal management to improve company decisions and operations.
  • Responds to RFP/RFI proposals for large segments of business regarding benefit information or design.
  • Acts as benefit expert and resource across internal departments for ongoing benefit administration.
  • Assists with special benefit development and management projects and other related tasks as assigned.
  • Performs benefit analyses to compare benefit levels between products using Excel and other tools and assists in presentation for senior management review.
  • Responds to inquiries regarding specific benefits, design, and modification as well as status information and general trouble-shooting to meet the needs of the business customer.

  • May conduct market research, data analysis, and benefit training.

  • Job Requirements