Insurance Plan Administrator - Medix : Job Details

Job Description:Seeking an experienced Insurance Product Administrator to build and manage various health plans like MECs, fully insured, level-funded and self-funded. The ideal candidate will ensure compliance with federal and state regulations, maintain plan documentation, and oversee participant communications. This role requires strong organizational skills and in-depth knowledge of health product design and service.Key Responsibilities:? Oversee the administration of MEC, fully insured, level-funded and self-funded health plans.? Ensure compliance with ACA, ERISA, and other applicable regulations.? Manage plan documentation, participant communications, and annual filings (SPDs, 5500s).? Collaborate with other departments to ensure seamless plan operations.? Handle escalated participant issues and complex cases.? Oversee the administration of MEC, fully-insured, level-funded, and self-funded health plans.? Analyze carrier data on complex clients and provide recommendations to account teams to helpwith the negotiation of rates and funding levels? Analyze and recommend optimal funding arrangements? Assist in marketing, analysis and placement of stop loss coverages? Price plan design and product alternatives? Assist in reviewing contracts, preparing RFP specifications, and identifying markets forproposals? Assist in the workflow for monthly and quarterly financial reporting for clients? Assist in negotiating rates with insurance carriers and other vendors? Provide technical expertise, product updates, and training programs? Follow industry development, changes, and legislative updates within all types planadministration methodology? Conduct special projects as neededQualifications:? Bachelor's degree in Business Administration, Health Management, or a related field.? Health and Life Insurance licensing required? 5+ years of experience in health plan administration, preferably with MEC or self-funded plans.? Strong knowledge of ACA and ERISA regulations.? Excellent communication and organizational skills.Skills Required:? Critical thinking and problem-solving skills? Excellent organization skills? Self-motivated, goal-oriented individual? Positive attitude and friendly demeanor? Excellent written, verbal, and interpersonal communication skills? Work independently and in a team environment? Strong computer skills and working knowledge of Google software