Benefit Consultant Job Description

Benefit Consultant Job Description

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Benefit consultant provides strategic consultative advice to clients around the design, delivery and ongoing management of their healthcare and risk benefit related programmes.

Benefit Consultant Duties & Responsibilities

To write an effective benefit consultant job description, begin by listing detailed duties, responsibilities and expectations. We have included benefit consultant job description templates that you can modify and use.

Sample responsibilities for this position include:

Demonstrate an extensive knowledge of the health care information management, managed care, or pharmacy benefit management industries
Ensure all legal notices including Summary Plan Descriptions, Summary Annual Reports and Plan Documents remain current based on plan design updates, legal requirements
Meets with clients to obtain all benefit related requirements for National accounts implementations
Reviews, defines, creates and maintains all related benefit documents for the implementation (Benefit plan design, benefits strings, OBN, Blue exchange)
Research and analyze RFP proposals and research existing group benefit definitions when deviations occur and provide consultative feedback to existing groups with status reports in weekly client meetings
Works with Account Managers to review SPDs and 2-pagers for Health Fairs
Provides requirements for all related systems that interchange with benefits (BOA, OBN)
Will provide technical support for post implementation research and correction of benefit issues
Designs and builds new complex non-standard benefit plans, reviews and analyze benefit summaries
Must be able to perform all duties of lower level Benefits Analyst positions as directed by management

Benefit Consultant Qualifications

Qualifications for a job description may include education, certification, and experience.

Licensing or Certifications for Benefit Consultant

List any licenses or certifications required by the position: MD, MPH, RN, CCM

Education for Benefit Consultant

Typically a job would require a certain level of education.

Employers hiring for the benefit consultant job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Associate Degree in Business, Management, Education, Finance, Economics, Business/Administration, Math, Statistics, Marketing, Actuarial Science

Skills for Benefit Consultant

Desired skills for benefit consultant include:

Healthcare delivery
Community
State and federal laws and resources
MS Office Tools
Pharmacy benefit set up and the company’s systems
Related experience
Computers and able to learn new systems and programs
Their DB Plans and building their confidence in Fidelity
Experience supporting the software development life cycle
Health care information management

Desired experience for benefit consultant includes:

Experience with Medicare and/or Medicaid Operations preferred
3-5 years experience in health insurance claims processing, analytical experience in a health care environment, or project management experience in a health insurance/ health care environment
5 + years of benefit coding/ configuration experience
Experience with FACETS benefits configuration strongly preferred
Minimum five (5) years of health care regulatory compliance and filing, contract writing, health care operations
Project management, health care regulatory compliance, filing, contract writing, benefits, health care operations

Benefit Consultant Examples

1

Benefit Consultant Job Description

Job Description Example
Our innovative and growing company is looking to fill the role of benefit consultant. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for benefit consultant
  • Provide mentorship and training to less experienced analysts
  • Lead, coordinate, or consult on the most complex or high exposure projects including new customer implementations, global projects spanning multiple clients or systems, and system implementations or enhancements
  • Accountable for multiple projects, such as estimating project scope, determining required resources, defining project tasks, and assigning work
  • Apply their expertise by collaborating on the translation and documentation of functional requirements into system specifications for systems development projects
  • Consult on product vision, planning, and forecasting
  • Assist all teams that work on National, Large Local business and Health and Welfare business
  • Assist Sales teams with various projects
  • Overall management and coordination of employer health plan benefits
  • Audit Sales documents for adherence to quality measures and reporting standards
  • Attend and participate in Finalist Presentations
Qualifications for benefit consultant
  • Working knowledge of dynamics and trends in health insurance industry and products in addition to HMOs
  • Proven relationship management skills - must gain cooperation and acceptance/approval in resolving problems, and/or negotiating with other stakeholders to arrive at an agreement
  • Strong writing and presentation skills, including the ability to clearly and concisely explain product information to a variety of audiences
  • Ability to synthesize a variety of data to produce a cohesive and well-documented product
  • Proven knowledge of project management principles and approach
  • Demonstrated ability to interpret quantitative and qualitative analyses and to communicate these to a variety of audiences
2

Benefit Consultant Job Description

Job Description Example
Our innovative and growing company is searching for experienced candidates for the position of benefit consultant. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for benefit consultant
  • The ability to work several hours of overtime each week during open enrollment, while maintaining a book of business and traveling
  • Partner with C&B leadership to set and execute benefit plan and vendor strategies
  • Facilitate implementation of new benefit plan design features and revise policy based on design changes
  • Manage vendor delivery and data interfaces – identify operating efficiencies
  • Develop and maintain plan and vendor summaries
  • Ensure legal, regulatory and contract compliance
  • Oversee benefit annual enrollment process
  • Coordinate resolution of member claims, appeals and escalated cases – partner with internal and external resources for timely execution
  • Provide oversight and approval for all related budgeting and invoicing processes
  • Lead vendor selection process – develop and negotiate contracts and renewals
Qualifications for benefit consultant
  • Demonstrated ability to motivate colleagues to embrace needed changes and instill confidence and respect in them
  • Proven ability to support colleagues and department objectives by learning new skills and demonstrated willingness to expand knowledge base
  • Minimum of 5 years of 401k administration experience (ESOP Administration experience is a plus)
  • Previous supervisory responsibility
  • ERISA designation/certification such as CPC, QPA or QKA a plus
  • Proven strong technical skills
3

Benefit Consultant Job Description

Job Description Example
Our growing company is hiring for a benefit consultant. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for benefit consultant
  • Actively manage plan and vendor performance – develop, evaluate and report key performance indicators
  • Manage projects to improve the overall customer experience and promote vendor efficiency and cost effectiveness
  • Supervise plan and vendor audits – identify and take action on trends and issues that have participant and process implications
  • Partner with C&B leadership to develop and deliver benefit-related communications
  • Work with Universities to determine benefit programs or best services
  • Analyze, test and implement systematic parameters to support plan provisions for new and existing Defined Benefit plans
  • Identify the standard business rules that need to be applied to the client’s data
  • Implement amendments and plan changes for the ongoing Defined Benefit business ensuring that all changes maintain the integrity of the system in the administration of the plan
  • Work closely with Retirement Services' systems and the DB business units to troubleshoot technical issues relative to benefit exchange activity
  • Ensure the system is in compliance with all past and current regulations
Qualifications for benefit consultant
  • Superior analytical, strategic planning, and communication skills
  • Extensive experience in a client-interfacing role in the consulting/benefits consulting industry
  • Proven management skills in leading large and complex projects
  • Ability to manage, engage, and coach staffs at all levels
  • Ability to lead change management initiatives and influence others
  • Include any exams, certifications, that must be completed prior to the start of the internship) Proficient in Power Point and Excel
4

Benefit Consultant Job Description

Job Description Example
Our company is growing rapidly and is hiring for a benefit consultant. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for benefit consultant
  • Oversees interpretation and communication of organization’s impact and community investment through charity care and community benefit initiatives
  • Ensures organizational priorities are addressed at policy, advocacy, legislative, and community groups and associations, such as the Texas Hospital Association, as related to legislative, policy and community issues impacting organizational operations
  • Serves as a catalyst for action in areas of community health and safety
  • Serves as consulting lead with relationships with elected and community leaders in outlying cities and counties in Seton’s primary service area such as Bastrop, Burnet, Caldwell and Hays
  • Provides ongoing analysis of Community Benefit classified activities and financials and develops improvement plans as deemed necessary
  • Work with Retirement Services Systems partners for special programming requests
  • Work closely with other members of the new business and ongoing operations team to identify, test, and quality review changes and initial set up of DB calculations
  • Assist the New Business team to define the business rules that need to be applied to the client’s data during the New Business conversion process
  • Assist in developing and determine impacts to the business for regulatory or discretionary changes
  • Mentor and train associates both existing and new hires on the benefit calculation system
Qualifications for benefit consultant
  • Proactively update own knowledge of changes in legislation through talking to other associates and reading appropriate news briefs/publications
  • Manage Risk benefit providers for own client base using negotiation and influencing skills as appropriate
  • Servicing and retaining existing clients with a high level of service and credibility
  • Plan and organise renewals
  • Design and redesign of benefits
  • Liaise with providers and insurers for information
5

Benefit Consultant Job Description

Job Description Example
Our innovative and growing company is looking for a benefit consultant. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for benefit consultant
  • Assist in various departmental projects as needed
  • Self-starter who can work in a team environment, independently
  • Experience with Defined Benefit plans
  • Experience with SQL and relational databases helpful, but not required
  • Ability to prioritize and manage multiple tasks successfully
  • Industry Knowledge – need to understand all regulatory items that affect a participant’s calculation and the application of that provision by the calculation system
  • Winning Ways
  • Oversee the implementation process in coordination with account team and MarketLink team to ensure that key implementation milestones are met, and host the scheduled implementation calls with the account team and client
  • Drive requirement elicitation and requirement maturation for projects to shorten the go-to-market time on project delivery to ensure user friendly outcome of projects
  • Responsible for defining the principles of Configuration Design for the KPCC platform to ensure accurate and timely claims payment consistent with the Regional and National artifacts
Qualifications for benefit consultant
  • Comprehensive & up-to-date technical knowledge & practical experience in the areas of Employee Benefits
  • Excellent grounding in group risk policies and providers
  • Good standard of written and oral communication
  • The ability to work with minimum supervision and within cross-disciplinary teams
  • Computer literacy of Microsoft Office software, in particular Word and Excel
  • An understanding and appreciation of broader international and employee health issues would be an advantage and a key to future progression

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