Senior Health Plan Pricing Analyst

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.

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 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.

• 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
• Conduct review of a prospect’s current medical offerings
• Ensure compliance with all carrier partner requirements
• Review complex cases such as self-funded groups and those over 100 employees
• Actively collaborate with Sales colleagues
• Assist is with reviewing and evaluating the output of the tools and resources Tri Net uses
• Assist in training of new colleagues and ongoing training of new colleagues
• Other project and responsibilities may be added at the manager's discretion
• Performs other duties as assigned
• Complies with all policies and standards

• Bachelor's Degree or equivalent experience preferred

• Typically 5+ years in insurance pricing or underwriting required

• Exceptional knowledge of health plan pricing
• Ability to interpret and analyze detailed medical plans and related documents
• Experience with trend analysis, risk forecasting and claims evaluation
• Ability to interact with Sales to explain medical pricing guidelines, requirements, etc.
• Proficient in Microsoft Office Suite; specifically with Excel
• knowledge is preferred
• Ability to use mathematical skills to solve problems
• Demonstrates ability to exercise independent thinking and complete…