Senior Plan Documents Specialist

We exist for workers and their employers—who are the backbone of our economy. Centivo’s mission is to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills.

About the role

The Senior Plan Documents Specialist works cross-functionally with Configuration, Implementation, Client Success, and Product teams to ensure best-in-class output, client experience, and satisfaction. This role involves regular interaction with brokers, agents, TPAs, stop-loss carriers, and other vendors and clients. As a key member of the delivery team, you will facilitate client onboarding for document preparation, client changes, document management, and other duties related to employer-sponsored welfare benefit plans under federal and employment laws, including:

• Employee Retirement Income Security Act (ERISA)
• Internal Revenue Code (Code)
• Health Insurance Portability and Accountability Act (HIPAA)
• Medicare Secondary Payer Act (MSP)
• Consolidated Omnibus Budget Reconciliation Act (COBRA)
• Affordable Care Act (ACA)
• Women’s Health and Cancer Rights Act (WHCRA)

Responsibilities

• Verify eligibility status and plan requirements to ensure accurate inclusion in plan documents.
• Draft, finalize, and maintain non-standard or moderately complex benefit plan documents (including SBCs, SPDs, and SMMs) by identifying and understanding change requests and their requirements, with little to no assistance from the Plan Documents Manager.
• Assist with client and internal department inquiries escalated due to SBC and SPD language concerns, compliance issues, or customization requests, with support from the Plan Documents Manager when needed.
• Support PDM vendor communications, including discussions related to federal/state mandates, governmental changes, or customized requests, in collaboration with the Plan Documents Manager.
• Support client communications, including—but not limited to—introductory client calls.
• Manage and maintain a book of business related to Mid-Market, Enterprise, or Strategic accounts, and/or assigned projects as directed by the Plan Documents Manager.
• Assist Junior team members with more complex drafting requests.
• Support the training of Analysts, Junior team members, or newly hired Senior team members at the direction of the Plan Documents Manager.

Requirements

• 3–5 years of employee benefits paralegal or similar professional experience.
• 3–5 years of experience in Health and Welfare benefits consulting with ERISA and Non-ERISA plans.
• 3–5 years of experience in client management related to self-funded plan document creation and management.
• Exposure to plan/policy documents, including amendments and SMMs, in prior work environments.

Skills

• Strong organizational and multi-tasking skills with exceptional attention to detail.
• Ability to manage time effectively, set priorities appropriately, and meet deadlines.
• Demonstrated ability to meet performance goals, including accuracy and productivity.
• Ability to work independently with minimal supervision.
• Typing speed of 60–70 WPM.

Preferred Qualifications

• Bachelor’s degree or equivalent job experience.
• Paralegal or related degree.
• Experience using Phia Group’s PDM online portal or similar document management platforms.
• Experience working with DOL Summary of Benefits and Coverage (SBC) templates and the SBC Coverage Examples Calculator.
• Compliance or insurance-related certifications.
• Claims litigation experience and/or insurance-related designations.
• 1–3 years of prior training experience.

About Centivo

Centivo is an innovative health plan for self-funded employers on a mission to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills. Anchored around a primary care-based ACO model, Centivo saves employers 15 to 30 percent compared to traditional insurance carriers. Employees also realize significant savings through free primary care (including virtual), predictable copays, and a no-deductible benefit plan design. Centivo works with employers ranging in size from 51 employees to Fortune 500 companies.

Headquartered in Buffalo, NY, with offices in New York City and Buffalo, Centivo is backed by leading healthcare and technology investors, including a recent round of investment from Morgan Health, a business unit of JPMorgan Chase & Co.

Pay

$75,000 – $85,000 per year

Schedule

Full remote