Job Description

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)

Responsibilities Include:

• 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

Qualifications:

Required Skills and Abilities:

• 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

Education and Experience:

• 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

Preferred Qualifications:

• 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

Work Location:

Located in our Buffalo, NY office or fully remote.

People Manager Leadership Behaviors

• Communicate – Managers discuss the company’s vision and strategies, the department’s direction and goals, and in times of crisis, what we know and don’t know to make sure team members know what they need to know.​

• Clarify – As managers, it’s up to us to clarify what good looks like. What do we expect? What do our clients, customers or colleagues need? If our teams are not performing as expected, managers must clarify expectations and ensure understanding.​

• Coach – Managers provide recognition and feedback; help team members find solutions to challenges; amplify good and filter weaker aspects of organizational culture and the work as they coach employees in their day-to-day performance and their growth and career development.​

• Connect – Managers help our teams see their collective purpose and how their work connects to the greater whole. We connect people within our company and network.​

• Customize –Managers must adapt how we delegate, how we clarify, how we coach, how we communicate and how we connect depending on the individual and task.

Centivo Values:

• Resilient – This is wicked hard. There is no easy button for healthcare affordability. Luckily, the mission makes it worth it and sustains us when things are tough. Being resilient ensures we don’t give up.

• Uncommon - The status quo stinks so we had to go out and build something better. We know the healthcare system. It isn't working for members, employers, and providers. So we're building it from scratch, from the ground up. Our focus is on making things better for them while also improving clinical results - which is bold and uncommon

• Positive – We care about each other. It takes energy to do hard stuff, build something better and to be resilient and unconventional while doing it. Because of that, we make sure we give kudos freely and feedback with care. When our tank gets low, a team member is there to be a source of new energy. We celebrate together. We are supportive, generous,

Who we are:

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.