Plan Documents Manager

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

Under the guidance of the VP Claims Operations, the Plan Documents Manager will work cross-functionally with the Configuration, and Client Success to ensure best-in-class output, client experience, and satisfaction, which can include regular interaction with brokers, agents, TPAs, stop loss carriers, and other applicable vendors and clients.

The Plan Documents Manager is a key member the Operations team, facilitating client onboarding for document preparation, client changes, document management, and other duties related to requirements for employer-sponsored welfare benefit plans under the following federal and employment laws:

• Employee Retirement Income Security Act (ERISA)

• Internal Revenue Code (Code)

• Health Insurance Patient 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)

• →

  Manage the Plan Documents team’s workload and task assignments to support coordination and completion (drafting) of Centivo’s SBC’s, SPD’s, SOB’s

• →

  Identify workflow process improvements, working with the management team to implement changes and/or create policy and procedures

• →

  Train new hires in the functionality of PDM, including teaching the mechanics of how it works, utilizing the checklist, and creating and maintaining document management

• →

  Attend meetings and collaborate with other departments as needed for representation of the Plan Documents team

• →

  Assist in client implementation and client plan changes, defining clients' benefits and structure for document preparation and required plan document creation

• →

  Manage benefit plan documentation processes

• →

  Conduct and manage complete, section-by-section review of prospective conversion plan documents, including Summary Plan Descriptions (SPD), Summary of Material Modification (SMM), plan amendments, and Summary of Benefits and Coverage (SBC)

• →

  Verify eligibility status and requirements from the plan to be included in the documents

• →

  Draft, finalize, and maintain benefit plan documents (SBCs, SPDs, SMMs)

• →

  Identify missing items needed for document preparation

• →

  Submit finalized plan documents and any changes to stop loss carriers

• →

  Determine changes to plan documents to ensure accuracy, seamless coverage, and necessary updates

• →

  Support client communications, including introductory calls

• →

  Supply team members with information and reference documents on compliance and regulatory changes

• →

  Stay current on requirements under ERISA, PPACA, and other related laws/regulations as they relate to plan benefits

• →

  Elevate client issues and concerns to appropriate leadership or Client Success team members

• →

  Perform other miscellaneous projects, assignments, and duties as assigned

• Phia Group’s PDM online portal document management experience or similar use of a portal for document creation and management

• Prior lead or management experience in plan document drafting and management

• Demonstrated abilities with process development and improvement as well as change management

• Strong organizational and multi-tasking skills, attention to detail

• Excellent written, verbal, and interpersonal communication skills

• Ability to manage time effectively, set priorities effectively, and meet deadlines

• Advanced knowledge of Microsoft Office products (Excel, PowerPoint, Word)

• Demonstrated ability to meet performance goals, including accuracy and productivity

• Ability to take initiative and be self-motivated while exercising proactivity in problem-solving and appropriate decision-making

• Ability to work independently with minimal supervision

• 5+ years’ employee benefits paralegal or similar job experience required

• 5+ years’ experience in Health and Welfare benefit consulting in ERISA & Non-ERISA plans

• 5+ years’ experience in client management in self-funding document creation and management

• Associate degree required; Bachelor’s degree preferred or equivalent job experience

Located in our Buffalo, NY office or fully remote.

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 our free primary care (including virtual), predictable copay and no-deductible benefit plan design. Centivo works with employers ranging in size from 51 employees to Fortune 500 companies. For more information, visit centivo.com.

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.