Benefit Contracts Specialist

7 days ago

Coeur d'Alene, Idaho, United States Cambia Health Solutions Full time
About the Role

We are seeking a highly skilled Benefit Contracts & Compliance Analyst to join our team at Cambia Health Solutions. As a key member of our Benefit Contracts Compliance team, you will play a critical role in developing and maintaining member enrollment materials, including booklets, contracts, and Summary of Benefit Changes (SBCs). Your expertise will ensure that our members receive accurate and timely information about their benefits.

Key Responsibilities
  • Research, draft, and produce collateral for use by operations support, marketing, and sales divisions.
  • Negotiate and coordinate with internal and external business partners to develop, write, revise, file, and coordinate the production of contracts and certificates of coverage for all lines of business.
  • Investigate and respond to contract interpretation requests, ensuring proper administration across divisions.
  • Establish and maintain an effective working relationship with the Insurance Department to facilitate regulatory compliant form filings.
  • Access and navigate the electronic publishing system used for creation of member contracts/booklets/plan documents/summary plan descriptions.
  • Collaborate with other divisions to develop new products and modify existing ones, ensuring competitiveness and efficient service to clients.
Requirements
  • Bachelor's Degree in Healthcare, English, business, or health care administration, communications, or related field.
  • 3 years of work-related experience or equivalent combination of education and experience.
  • Strong organizational skills with a demonstrated ability to prioritize, coordinate, and implement multiple projects within varied or simultaneous time constraints.
  • Ability to coordinate activities with all levels of staff within the Plan and external agencies through clear and concise verbal and written communication skills, including tactful and persuasive negotiation skills.
  • Ability to work independently and exercise sound judgment while developing solid working relationships with internal and external business partners.
  • Ability to comprehend, master, and draft all aspects of the Plan's contracts/booklets, benefits administration, and overall business processes for all lines of business/products.
  • Demonstrated technical skills necessary to effectively navigate the electronic publishing system used for document creation.
  • Ability to work in high-pressure circumstances on multiple concurrent projects involving multidisciplinary, unconnected tasks, and proven ability to initiate and independently produce detailed and highly accurate work.
  • Knowledge of the health insurance industry, including benefit design and compliance issues, with capability of incorporating into contracts and other related materials.
  • Experience/understanding and knowledge of federal laws and guidelines, including but not limited to COBRA, HIPAA, ERISA, USERRA, DOL, etc., and applicable state insurance code and regulations, including the Affordable Care Act (ACA).
What We Offer
  • Competitive salary range: $60,000 - $82,000/year, depending on skills, experience, education, and training.
  • Bonus target: 5%.
  • Current full salary range: $57,000 - $94,000/year.
  • Generous benefits package, including medical, dental, and vision coverage, annual employer contribution to a health savings account, paid time off, and more.
About Cambia Health Solutions

Cambia Health Solutions is a purpose-driven, award-winning company built on trust and innovation. Our caring and supportive colleagues are some of the best and brightest in the industry, innovating together toward sustainable, person-focused healthcare. We are committed to helping our members live healthy lives and are dedicated to creating a positive impact in our communities.

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