Sr Health Plan Pricing Analyst

Trinet Group; Vadali; On-site; INR 1,400,000 - 2,300,000; Full time

Job summary

TriNet Group is seeking a Senior Health Plan Pricing Analyst to determine medical pricing based on group risk using specialized pricing tools. The role also trains new colleagues and serves as a liaison with carrier pricing teams.

The candidate will review census data, assess plans and rates, and collaborate with Sales on pricing guidelines. This position is 100% in-office and part of the Insurance Services team.

Qualifications

• Bachelor's degree or equivalent experience required.
• 5+ years in insurance pricing or underwriting.

Responsibilities

• Determine an appropriate medical price based on group risk using pricing tools.
• Review census data and plan rates to provide recommendations.
• Collaborate with Sales on pricing guidelines.
• Evaluate self-funded and large groups (over 100 employees).
• Assist in training new colleagues and ongoing education.
• Review tool outputs and pricing resources for accuracy.
• Support manager on additional projects as needed.
• Ensure compliance with policies and standards.

Skills

Medical pricing

Data analysis

Excel

Salesforce knowledge

Independent thinking

Cross-functional collaboration

Education

Bachelor's degree

Tools

Pricing tools

Job description

Job Summary

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
• Conducts prospect census review and review of a prospects medical plans and rates to provide recommendations
• Actively collaborate with Sales colleagues
• Review complex cases such as self-funded group and those over 100 employees
• Assist in training of new colleagues and ongoing training of new colleagues
• Assist is with reviewing and evaluating the output of the tools and resources TriNet uses
• Other project and responsibilities may be added at the managers discretion
• Performs other duties as assigned
• Complies with all policies and standards

Education Qualifications

• Bachelors Degree or equivalent experience required

Experience Qualifications

• Typically 5+ years in insurance pricing or underwriting required

Skills and Abilities

• Ability to interpret and analyze detailed medical plans and related documents
• Ability to handle multiple tasks and prioritize projects
• Proficient in Microsoft Office Suite; specifically with Excel
• Salesforce.com knowledge is preferred
• Exceptional knowledge of health plan pricing
• Ability to use mathematical skills to solve problems
• Demonstrates ability to exercise independent thinking and complete projects with little guidance
• Ability to interact with Sales to explain medical pricing guidelines, requirements, etc

Travel Requirements

• Minimal

Work Environment

• Work in clean, pleasant, and comfortable office or home setting. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable persons with disabilities to perform the essential functions.
• This position is 100% in office