Attentive® is the AI-powered SMS and email marketing platform that delivers unparalleled messaging performance on the channels that matter most. Infusing intelligence at every stage of the consumer's purchasing journey, Attentive empowers businesses to achieve hyper-personalized communication with their customers on a large scale. Leveraging AI-powered tools, a mobile-first approach, two-way conversations, and enterprise-grade technology, Attentive drives billions in online revenue for brands around the globe. Trusted by over 8,000 leading brands such as CB2, Urban Outfitters, GUESS, Dickey’s Barbeque Pit, and Wyndham Resort, Attentive is the go-to solution for delivering powerful commerce experiences for consumers with the brands they love.
Who we are
We are looking for an individual with strong technical expertise for a critical role within the Total Rewards Team. Reporting to our Senior Manager, Global Benefits, this person will manage the overall administration, oversight, analysis, and claims management of our self-funded medical plan.
The role involves ensuring compliance with regulations, analyzing healthcare cost trends, and working closely with third-party administrators (TPAs) to manage claims, cost containment, and reporting. This analyst is vital in optimizing plan design, reducing costs, and ensuring that the plan meets employee needs while adhering to organizational goals.
Plan Administration:
- Oversee the day-to-day operations of the self-funded medical plan, including claims processing, funding, and reporting
- Work with TPAs to ensure timely and accurate claim adjudication and manage any escalated claim issues
- Work with the finance team to monitor cash flow to ensure that the plan is adequately funded for claim payments and administrative costs
- Oversee Claim Management and Claims Resolution
- Work with Finance to resolve billing question
- Manage High Cost Claim Notifications
- Review Plan Exceptions and flag to the committee for review as appropriate
- Facilitate Monthly Claim Review Meetings with People, Finance, and the Carrier
Cost Analysis & Reporting:
- Analyze healthcare cost trends, claims data, and utilization patterns to identify cost drivers and opportunities for cost savings
- Generate detailed financial reports on the performance of the self-funded plan, including stop-loss analysis, claim frequency, and large claims tracking
- Provide recommendations based on claims data and financial performance analysis
Compliance:
- Ensure the self-funded plan complies with federal and state regulations, such as ERISA, HIPAA, and the ACA
- Assist in preparing required filings, such as Form 5500, ACA, PCORI, and Summary Plan Descriptions (SPDs)
- Prepare, manage, and send required compliance notices
- Manage Health Care Committee governance, meeting preparation, and charter maintenance
- Stay up-to-date with regulatory changes that affect self-funded plans and ensure compliance, such as Pharmacy Gag Clause and Mental Health Parity Compliance
Vendor & Partner Management:
- Collaborate with the broker to negotiate contracts and terms to optimize plan costs with TPAs, stop-loss carriers, and other vendors
- Serve as the primary point of contact between the organization and external vendors for the self-funded plan
- Conduct performance reviews of vendors and ensure service level agreements (SLAs) and performance guarantees (PGs) are met
Plan Design & Optimization:
- Assess plan design annually (At minimum) and recommend modifications to reduce costs, improve care management, and/or align with employee needs
- Work with actuarial consultants to project costs and set stop-loss limits
- Evaluate wellness programs, disease management initiatives, and other health interventions to enhance plan performance
- Develop utilization dashboards for our entire suite of benefits and benefit line features and report on it monthly
Employee Communication & Education:
- Develop and implement communication strategies to ensure employees understand their medical benefits, claims processes, and any changes to the plan
- Serve as the primary contact for employee inquiries related to the self-funded medical plan
- Organize workshops or informational sessions to educate employees about the medical plan and its features
- Resolving Coverage Questions relating to the self-funded plan
About you
- Bachelor’s degree in Finance, Business, Healthcare Administration, or related field.
- 3-5 years of experience with self-funded health plans or benefits administration.
- In-depth knowledge of healthcare regulations and compliance (ERISA, ACA, HIPAA, et all).
- Strong analytical skills and experience with claims data analysis and cost reporting.
- Proficiency in benefits management software and advanced Excel skills.
- Excellent communication skills.
- Designations preferred but not required: CEBS or GBA
- Tools: ADP Workforce Now (HRIS & Payroll Systems), Fidelity, Guardian, Lincoln, Cigna, and Kaiser (Benefit Portals) Jira & Confluence, (Internal Tools & Help Desks) Google Suite (Mail, Drive, Sheets, Docs, & Slides), Adobe Acrobat Pro
- Job Classifications: Salary Exempt, Benefits Eligible, 0% Travel Required, Supervisory Responsibility - None, Physical Requirement - Prolonged periods sitting at a desk and working on a computer
You'll get competitive perks and benefits, from health & wellness to equity, to help you bring your best self to work.
For US based applicants:
- The US base salary range for this full-time position is $100k - $125k base + equity + benefits
- Our salary ranges are determined by role, level and location
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Attentive Company Values
Default to Action - Move swiftly and with purpose
Be One Unstoppable Team - Rally as each other’s champions
Champion the Customer - Our success is defined by our customers' success
Act Like an Owner - Take responsibility for Attentive’s success
Learn more about
AWAKE, Attentive’s collective of employee resource groups.
If you do not meet all the requirements listed here, we still encourage you to apply! No job description is perfect, and we may also have another opportunity that closely matches your skills and experience.
At Attentive, we know that our Company's strength lies in the diversity of our employees. Attentive is an Equal Opportunity Employer and we welcome applicants from all backgrounds. Our policy is to provide equal employment opportunities for all employees, applicants and covered individuals regardless of protected characteristics. We prioritize and maintain a fair, inclusive and equitable workplace free from discrimination, harassment, and retaliation. Attentive is also committed to providing reasonable accommodations for candidates with disabilities. If you need any assistance or reasonable accommodations, please let your recruiter know.
