Senior Health Plan Pricing Analyst Job Atlanta area,Georgia USA,Insurance

Tri Net is a leading provider of comprehensive human resources solutions for small to midsize businesses (SMBs). We enhance business productivity by enabling our clients to outsource their HR function to one strategic partner and allowing them to focus on operating and growing their core businesses. Our full-service HR solutions include features such as payroll processing, human capital consulting, employment law compliance and employee benefits, including health insurance, retirement plans and workers’ compensation insurance.

Tri Net has a nationwide presence and an experienced executive team. Our stock is publicly traded on the NYSE under the ticker symbol TNET. If you’re passionate about innovation and making an impact on the large SMB market, come join us as we power our clients’ business success with extraordinary HR.

Don't meet every single requirement? Studies have shown that many potential applicants discourage themselves from applying to jobs unless they meet every single requirement. Tri Net always strives to hire the most qualified candidate for a particular role, ensuring we deliver outstanding results for our small and medium-size customers. So, if you're excited about this role but your past experience doesn't align perfectly with every single qualification in the job description, nobody’s perfect – and we encourage you to apply.

You may just be the right candidate for this or other roles.A Brief Overview

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 Tri Net'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 medical insurance underwriting and/or PEO health plan pricing having mastered the nuances of pricing and is a key contributor to the team.

What You Will Do

Evaluate employer group risk characteristics, demographic data, claims experience, and supporting documentation to determine appropriate medical pricing and underwriting decisions
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
Analyze census data, benefit plan designs, medical rates, and underwriting information to assess risk exposure and recommend pricing actions
Review complex cases, including large groups, self-funded plans, and high-risk accounts, to ensure sound pricing decisions.
Identify trends, inconsistencies, or risk factors that may impact pricing accuracy, profitability, or plan performance
Collaborate with Revenue, Carrier Partners, and internal stakeholders to communicate pricing requirements, pricing rationale, and risk considerations.
Assist with process improvements, tool enhancements, training, and mentoring of less experienced underwriting colleagues as required
Ensure compliance with all carrier partner requirements
Assist in training of new colleagues and ongoing training of new colleagues
Performs other duties as assigned
Complies with all policies and standards

Education Qualifications

Bachelor's Degree or equivalent experience preferred

Experience Qualifications

Typically, 5+ years in insurance pricing or underwriting required

Skills And Abilities

Strong analytical and quantitative skills.
Knowledge of medical underwriting principles, health plan design, and risk…