The posting
This position is responsible for providing support to United States based Health and Benefits Consultants and Clients. Within this role, as a member of North America client team, you will collect and analyze data that informs strategic business decisions. The expectation will be to produce several clients facing analytical reports efficiently and accurately.
Your role on individual projects will include elements such as data collection from vendors/ carriers, data validation, data extracts, conducting focused analyses, developing executive summary for senior H&B stakeholders & client presentations, developing management reports and other activities.
You will continually learn about North America health and benefits concepts and principles and apply these skills in a global environment. Finally, you will interact with other members of our United States Health and Benefits team and can make important contributions to process improvements and new analytical tools.
This position requires an analytical mind who is detail oriented with work product and outputs using Microsoft Office tools. The position also requires the ability to accurately execute written and verbal instructions.
The Role:
Manage NQTL operational data portion of parity assessment, including:
- Prepare NQTL carrier operational data requests on behalf of each client/carrier.
- Coordinate with Project Manager regarding sending requests, timing, status, and follow-up.
- Attend internal and client kick off meeting with QTL/NQTL team.
- Monitor carrier and vendor responsiveness to data requests
- Validate completeness of response and report any issues or impact to timeline proactively to Project Manager.
- Complete initial review of carrier responses for parity projects.
- Map carrier responses to appropriate section of NQTL document.
- Cite specific reference, criteria, and example(s) for each response.
- Draft gap analysis based on documents reviewed including master templates and client specific responses.
- Collaborate with health management senior reviewer and Project Manager to conduct follow up calls/emails with carriers/vendors as needed for clarification and submission of additional documentation.
- Support the overall completion of the NQTL operational data component of the report.
- Schedule meetings and coordinate efforts of colleagues.
- Participation in weekly or bi-weekly project status calls as needed.
- Participate in MHPAEA office hours as needed.
- Maintain materials/documentation in a manner consistent with the company's work processes and peer review standards (e.g., filing of drafts, deliverables, client and carrier documentation)
Qualifications:
- Graduate of Bachelor of Science in Information Technology or related courses.
- 2-5 years experience dealing with health and welfare plans, ideally gained in a benefit consulting/brokerage firm, Health Plan, Third Party Administrator, Regulatory Agency, Legal/Compliance Firm, or insurance company
- US Registered Nurse or LCSW with active licensed preferred
- Health analytics experience preferred.
- Understanding of health plan utilization/case management processes, network management, credentialing, quality management, pharmacy prior-authorization processes and health plan operations.
- Basic understanding of Mental Health Parity and Mental Health Parity Non-Qualitative Treatment Limits.
- Well-organized and detail oriented.
- Strong project management and critical thinking skills.
- Self- starter attitude and ability to work individually and as part of a team.
- Strong written and verbal communication skills.
- Sense of accountability and ownership.
- Flexibility and proven ability to identify and resolve issues.
- Strong analytical, creative, and integrative skills.
- Ability to ask the right questions and seek help where appropriate, from colleagues and clients.
- Strong client service orientation and ability to respond to all communications effectively and in a timely manner.
- Excellent Microsoft Office skills, particularly in Excel and Power Point.
