Senior Health Plan Pricing Analyst at TriNet in Irvine, CA, United States

Job description

• The Senior Health Plan Pricing Analyst is responsible for multiple tasks within the department including ensuring the appropriate medical rate is assigned for a prospect. This role uses specialized tools developed by third party industry experts and TriNet's carrier partners to evaluate submitted documents and census information to determine the correct medical pricing for prospects based on the actual risk they present. In addition, their role is to assist the manager with the training of new colleagues as well as a primary liaison with carriers and the carrier pricing teams. This role will be an expert in the field of PEO health plan pricing having mastered the nuances of pricing and is a key contributor to the team. This position is part of the development process for grooming colleagues into the next level of leadership within the Insurance Services team and the Health Plan Pricing department.

Responsibilities

• Work independently to determine an appropriate medical price based on the risk of the group using multiple tools such as the parity testing tool and medical pricing tool
• Conduct review of a prospect’s current medical offerings
• Ensure compliance with all carrier partner requirements
• Review complex cases such as self-funded groups and those over 100 employees
• Actively collaborate with Sales colleagues
• Assist is with reviewing and evaluating the output of the tools and resources TriNet uses
• Assist in training of new colleagues and ongoing training of new colleagues
• Other project and responsibilities may be added at the manager's discretion
• Performs other duties as assigned
• Complies with all policies and standards

Requirements

• Bachelor's Degree or equivalent experience preferred
• Typically 5+ years in insurance pricing or underwriting required
• Exceptional knowledge of health plan pricing
• Ability to interpret and analyze detailed medical plans and related documents
• Experience with trend analysis, risk forecasting and claims evaluation
• Ability to interact with Sales to explain medical pricing guidelines, requirements, etc.
• Proficient in Microsoft Office Suite; specifically with Excel
• Salesforce.com knowledge is preferred
• Ability to use mathematical skills to solve problems
• Demonstrates ability to exercise independent thinking and complete projects with little guidance
• Ability to handle multiple tasks and prioritize projects

Skills

Preferred

• Salesforce.com knowledge is preferred

Benefits

• Additionally, subject to applicable eligibility requirements, TriNet offers permanent full-time employees a variety of benefits including medical, dental, and vision plans, life and disability insurance, a 401(K) savings plan, an employee stock purchase plan, eleven (11) Company observed holidays, PTO and a comprehensive leave program. Please click the following link for detailed information about our benefits offerings: https://www.trinet.com/documents/blt5b61a1040aae1904
• The preferred location for this role is Irvine, CA, and the salary range for this location is $85,000.00 to $159,250.00. All qualified external applicants will be considered for an in-office role, based in Irvine. All qualified internal candidates are encouraged to apply and consider relocation to Irvine and may be considered for remote hire at the company’s discretion. The candidate’s final salary offer will be based on the candidate’s skills, education, work location and experience.
• A candidate’s compensation may also include bonuses consistent with TriNet’s corporate bonus plan.