Note: The job is a remote job and is open to candidates in USA. Edison Health Solutions, a Relation Insurance company, is a leading organization in the insurance market, seeking a Health Plan Specialist. This role involves creating and maintaining compliant health plan documentation and ensuring that all materials meet regulatory requirements while collaborating with cross-functional teams.
Responsibilities
- Creates, maintains, and updates PHIA-regulated Summary Plan Descriptions (SPDs) and Plan Documents for ERISA and non-ERISA health plans, ensuring compliance with all applicable regulations
- Produces Summaries of Benefits and Coverage (SBCs) in accordance with federal and state compliance requirements
- Manages plan renewals and drafts plan amendments, ensuring accuracy, consistency, and timely delivery across a high-volume document environment
- Supports the production and delivery of 80+ plan documents per month, adhering to established timelines and quality standards
- Participates in client implementation meetings to review benefit outlines, clarify plan requirements, and gather all necessary information prior to document creation
- Collaborates with cross-functional teams (e.g., implementation, compliance, operations) to ensure plan materials are aligned, compliant, and reflective of client expectations
- Conducts quality reviews to confirm plan documents accurately reflect approved benefit designs and regulatory requirements
- Maintains organized documentation records and version control in accordance with internal procedures and compliance standards
- Performs other projects, duties, and tasks, as assigned
Skills
- High School diploma or equivalent
- Bachelor's degree in Business, Health Administration, Public Policy, English, or related field; equivalent experience preferred
- Strong writing, editing, and proofreading skills with attention to detail
- Basic knowledge of employee benefits and health plan concepts (medical, Rx, dental, vision, HSA/HRA/FSA)
- Working knowledge of the laws and regulations associated with HIPAA
- Knowledge of and basic understanding of benefit plans & terminology
- Willingness to adhere to all principles of confidentiality
- Proficiency with Microsoft Word (templates/styles), Excel, and Adobe Acrobat
- Ability to manage multiple deadlines in a fast-paced, high-volume environment
- Excellent communication and collaboration skills
- A Life Accident and Health License from state of domicile is preferred
- Certified in Healthcare Compliance (CHC) is helpful
- Familiarity with plan document generation platforms or template libraries preferred
- Exposure to ERISA, ACA, HIPAA, COBRA, MHPAEA, and state benefit mandates preferred
- Familiarity with SBC templates and plan document generation platforms preferred
Benefits
- Family health and wellness programs
- 401K
- Employee assistance programs
- Paid time off
- Paid holidays
Company Overview
Despite our size, Relation feels like a family company. Here, a handshake matters. It was founded in 2007, and is headquartered in Walnut Creek, California, USA, with a workforce of 1001-5000 employees. Its website is https://www.relationinsurance.com.
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