Plan Compliance & Benefits Specialist
Looking for a way to influence the health and healthcare of many?
If so, we'd love to hear from you! Our mission-driven organization is focused on the"Triple Aim" - Better Health, Better Healthcare and Lower Costs to individuals and their families who participate in our health plans.
UNITE HERE HEALTH serves 100,000+ workers in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity!
- Integrity – Must be trustworthy and principled when faced with complex situations
- Ability to build positive work relationships – Mutual trust and respect will be essential to the collaborative relationships required
- Communication – Ability to generate concise, compelling, objective and data-driven reports
- Teamwork – Working well with others is required in the Fund's collaborative environment
- Diversity – Must be capable of working in a culturally diverse environment
- Continuous Learning – Must be open to learning and skill development. As the Fund's needs evolve, must be proactive about developing new areas of expertise
- Lives our values – Must be a role model for the Fund's BETTER Culture and Mission (Better, Engage, Teamwork, Trust, Empower, Respect)
This role is primarily responsible for developing, maintaining and updating all legally required/compliance benefit plan documents for the assigned Plan Units. This involves staying current with all applicable employee benefit law (ERISA, ACA, etc.) as it pertains to each Plan and working with various Staff to revise and build legally compliant, participant friendly communications.
- Ensure that all plan units comply with ERISA reporting and disclosure requirements, including creation and distribution of:
- Plan Documents,
- Summary plan descriptions (SPDs),
- Summaries of material modifications (SMMs),
- Summaries of benefits and coverage (SBCs), and
- Annual mailing of other required documents.
- Draft plan amendments and resolutions describing the proposed benefit change.
- Draft plan related documents and communication material in a manner compliant with all applicable state, federal and benefits related legislation and regulations.
- Review of benefit related discretionary communications.
- Investigate, analyze, and provide recommendations on benefit and compliance issues.
- Work with Manager of Plan Compliance & Benefits & Counsel on plan compliance and regulatory matters impacting benefits.
- Work with other departments (Claims, Healthcare Delivery, and Operations) on plan eligibility and benefit related issues.
- Collaborate and partner with other Plan Compliance and Benefits Specialist(s)/Analyst(s) to ensure consistency and uniformity in materials, responses to questions, and interpretations, where possible.
- Serve as a benefit and compliance expert.
- Perform other duties as assigned within the scope of responsibilities and requirements of the job.
- Perform Essential Job Functions and Duties with or without reasonable accommodation.
- Bachelor's Degree in health care or related field (or related field or equivalent work experience) required
- Master's degree in preferred
- 3+ years of increasing work responsibility
- Experience in a healthcare, benefits administration or compliance work role.
- Preferable experience in a Taft-Hartley environment, insurance company or consulting firm.
- Requires an excellent understanding of all facets of welfare benefit plans, as it relates to plan design and administration and therefore plan benefits and eligibility.
- Strong understanding of employee benefits legal environment, including statutory and regulatory requirement and the associated case law.
- Ability to:
- Interact effectively with all levels of staff
- Work independently, prioritize multiple projects, and attend to detail and deadlines to bring projects to a satisfactory conclusion
- Work in a team environment
- Conduct research and provide an analysis with a recommendation