Benefits Analyst III

Logistics and transportation



 


Job Summary and Mission



Responsible for complex research, analysis, evaluation, design recommendations and administration of corporate benefit plans/programs and delivery systems.  Creates complex reports, develops and maintains documentation of process flows, administrative summaries and standard operating procedures.  Facilitates relationships with clients, third party vendors and/or ancillary service providers and other internal parties to ensure seamless delivery of services and support systems. Supervises production operation activities and/or acts as lead for assigned staff members.


Models and acts in accordance with our guiding principles and core values. 


 


 


Summary of Key Responsibilities

Responsibilities and essential job functions include but are not limited to the following:
Supervise production operation activities to ensure a smooth and productive work flow process, quality service delivery and compliance with internal operating policies and procedures, and regulatory guidelines; and/or act as lead to assigned staff.
Work corroboratively with the Benefits team to ensure tasks associated with technical issues (including systems, legislative and operations control) are performed in a timely and accurate manner.
Develop and maintain documentation of process flows, administrative summaries, and standard operating procedures.
Create and generate complex and comprehensive analytical reports to track service delivery quality, identify needs, manage costs, and project carrier and industry trends.
Develop and recommend changes in Plan design.
Develop innovative processes and recommend changes for operational improvements that enhance service delivery and achieve efficiencies internally and with external partners..
Assist in the definition, development and maintenance of project and system requirements, technical specifications, and test plans.
Work with other internal groups to prepare test plans to support technical infrastructure testing, data interfaces in/out of the system, employee communications, employee tools (web, account inquiry screens and/or People Vision) and client reporting.
Work with client participants to resolve escalated, sensitive and confidential claims or access health care issues using extreme discretion and excellent customer service skills..
Work with Health Plans, key carrier contacts and other internal parties to resolve participant issues and follow-up with the participant to communicate resolutions to issues.
Coordinate with management to communicate global issues to the team via training or through other communication vehicles.
Develop working relationships with clients, third party vendors and/or ancillary service providers and other internal parties to ensure seamless delivery of specific tasks, special projects and/or participant issues.
Responsible for daily coaching, training and development of assigned staff.
Communicate urgent and/or unresolved issues to Benefits Manager in a timely manner.
Keep abreast of emerging technology changes and innovations through formal or informal study, reading business and professional publications, networking, and participation in professional organizations.



 


Summary of Experience and Education

High School Degree or GED required.
Bachelor’s Degree in Business Administration, Human Resources or related field preferred.
Minimum four to seven years experience required in health plan claim processing and customer service functions.


 


Knowledge, Skills and Abilities

In-depth knowledge and understanding of plan provisions and administration.
Extensive knowledge of benefits regulations and compliance requirements.
Ability to lead, mentor and coach staff members.
Must be detail oriented, with strong mathematical, logical, analytical and financial analysis skills.
Demonstrated skill in the creation of spreadsheets and complex reports.
Familiar with production workflow processes and service delivery systems.
Ability to manage complex or emotional participant situations promptly and professionally meeting commitments for service and assistance.
Ability to handle sensitive and/or confidential documents and information.
Ability to exercise professional judgment, diplomacy, patience and discretion in dealing with sensitive, confidential information.
Ability to identify and understand issues, problems and opportunities; comparing data from different sources to draw conclusions.
Skilled in exploring alternatives and positions to reach outcomes that gain all parties’ support and acceptance.
Utilizes reliable, consistent research and follow-up skills.
Must be flexible, able to balance multiple tasks and changing priorities.
Excellent planning, time management, collaboration, decision making, organization, presentation and negotiating skills.
Strong interpersonal skills and the ability to interact and build strong working relationships with all levels of the organization, vendors, third party and/or ancillary service providers.
Makes customers and their needs a primary focus of one's actions; developing and sustaining productive relationships.
Ability to maintain stable performance under pressure or opposition; handling stress in a manner that is acceptable to others and the organization.
Uses appropriate methods and a flexible interpersonal style to help build a cohesive team and facilitates the completion of team goals. 
Advanced proficiency in Microsoft Office Suite, internet, web-based and job specific software applications.
Working knowledge of Oracle Benefits module preferred.
Must be able to read, write and speak English fluently. 
Ability to communicate and interact effectively with multi-functional and diverse backgrounds. 
Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures or governmental regulations.
Ability to write reports, business correspondence, and procedure manuals.
Ability to effectively present information and respond to questions from employees, senior management, clients, customers, and the general public.


 


Licenses and Certifications

CEBS (Certified Employee Benefits Specialist) preferred.
PHR (Professional Human Resources) Certification preferred; or
SPHR (Senior Professional Human Resources) Certification preferred.


 


Travel

Travel is required at least 5% of the time in this position.  Travel identified is approximately 100% domestic (within the United States) and 0% international (outside of the United States).