Job Description

GENERAL SUMMARY:

Leads the strategy, financial oversight, vendor management, audit, data-driven decision-making, and performance monitoring of the company’s healthcare plan. This role collaborates across HR, Finance, Legal, and external partners and vendors to optimize cost, ensure compliance, and deliver a best-in-class benefits experience. This is a $16mm/year spend for our family of companies, and we are seeking someone to optimize every dollar spent, while ensuring our benefits remain a defining part of our culture as a “first choice” employer in our various industries. This role serves as the internal owner of the company’s healthcare spend, responsible for ensuring plan decisions are supported by data, aligned with fiduciary obligations under ERISA, and structured to maximize value for both the company and employees.

Essential Duties And Responsibilities:

• Strategy.
Lead the development and execution of the company’s healthcare plan strategy aligned with total cost of care, workforce objectives, and long-term financial sustainability.Identify and address structural cost drivers within the healthcare plan, develop risk mitigation strategies, evaluate cost-containment opportunities, and design plan structures that improve value while maintaining appropriate access and employee experience.
Evaluate vendor recommendations, market solutions, and plan design changes using claims data, financial analysis, and independent benchmarking to ensure decisions are supported by measurable value and aligned with company objectives.
• FP&A.
◦ Oversee the financial performance of the self-insured healthcare plan, including, price and utilization trend analysis, forecasting, and budgeting.
◦ Conduct in-depth cost analysis of healthcare plan data and reports to ensure appropriate and effective healthcare benefit spending and vendor oversight.
• Procurement.
◦ Lead end-to-end RFP process and contract negotiations for broker-consultants, third party administrators, pharmacy benefit managers, stop-loss carriers, and other benefit/wellness providers to ensure competitive pricing, services and guaranteed at risk performance.
◦ Require transparency in vendor data, subcontracting arrangements, pricing terms with third parties, health plan reporting and all real or potential conflicts of interest.
◦ Manage vendor performance and contract compliance, develop vendor performance standards, and implement regular reporting to senior management
Additional Duties And Responsibilities:
• Collaborate with HR to communicate and educate employees on healthcare benefits programs and drive consumer-driven culture change around healthcare utilization.

• Stay informed on healthcare issues impacting employer sponsored healthcare to ensure healthcare plan compliance and optimized cost benefit offerings.

Competencies:

• Advanced knowledge of health plan design, self-funded plan mechanics, and applicable regulatory requirements (ERISA, ACA, CAA, MHPAEA), including the practical application of these frameworks to plan governance and decision-making.
• Ability to interpret and analyze medical and pharmacy claims and utilization patterns, and unit cost trends to identify underlying cost drivers and inform strategic plan decisions.
• Vendor management, contract negotiation, and enforcement of performance guarantees and audit rights
• Financial analysis and budgeting for healthcare spending, including forecasting and trend modeling, and evaluation of financial impact associated with plan design, utilization changes, and vendor performance.
• Ability to communicate complex financial or contractual concepts to executives and employees
• Strategic thinking to design cost-effective, high-value benefits aligned with business objectives
• Problem solving and decision-making using data, benchmarking, and contractual levers

Educational/Vocational/Previous Experience Recommendations:

• Relevant Bachelor’s degree required. MBA, JD, and/or CPA preferred.
• Minimum of 5 years of related experience or training.
• The company recognizes that strong candidates for this role may come from a variety of professional backgrounds. Experience may include employer-sponsored healthcare, benefits strategy, healthcare analytics, consulting, finance, procurement, vendor management, or healthcare operations.

Candidates should demonstrate experience working with complex data, managing or influencing financial outcomes, and collaborating across internal stakeholders and external vendors to drive measurable results.

Experience supporting or managing self-funded health plans and working with healthcare vendors such as TPAs, carriers, pharmacy benefit managers, or benefits consultants is strongly preferred but not required.

Working Conditions:

• Normal office environment. This position is primarily based at company office locations; however, a hybrid work arrangement may be considered for the right candidate based on role requirements and business needs.
• This position requires up to 20% travel, primarily to main office locations and meetings with key internal and external partners.

The statements above are intended to describe the general nature and level of work being performed by people assigned to this job. Other duties may be assigned as needed.