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.

Centivo is hiring a Senior Plan Documents Specialist! The Plan Documents Specialist will work cross-functionally with the Configuration, Implementation, Client Success, and Product teams 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 Specialist is a key member of the delivery 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:

• Verify eligibility status and plan requirements to ensure accurate inclusion in plan documents.

• Draft, finalize, and maintain non-standard or moderately complex benefit plan documents (including SBCs, SPDs, and SMMs) by identifying and understanding change requests and their requirements, with little to no assistance from the Plan Documents Manager.

• Assist with client and internal department inquiries escalated due to SBC and SPD language concerns, compliance issues, or customization requests, with support from the Plan Documents Manager when needed.

• May assist with PDM vendor communications, including discussions related to federal/state mandates, governmental changes, or customized requests, in collaboration with the Plan Documents Manager.

• Support client communications, including—but not limited to—introductory client calls.

• Manage and maintain a book of business related to Mid-Market, Enterprise, or Strategic accounts, and/or assigned projects as directed by the Plan Documents Manager.

• Assist Junior team members with more complex drafting requests.

• Support the training of Analysts, Junior team members, or newly hired Senior team members at the direction of the Plan Documents Manager

Required Skills and Abilities:

• Strong organizational and multi-tasking skills with exceptional attention to detail.

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

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

• Ability to work independently with minimal supervision.

• Typing speed of 60–70 WPM.

Preferred Qualifications:

• Bachelor’s degree or equivalent job experience.

• Paralegal or related degree.

• Experience using Phia Group’s PDM online portal or similar document management platforms.

• Experience working with DOL Summary of Benefits and Coverage (SBC) templates and the SBC Coverage Examples Calculator.

• Exposure to plan/policy documents, including amendments and SMMs, in prior work environments.

• Compliance or insurance-related certifications.

• Claims litigation experience and/or insurance-related designations.

• 1–3 years of prior training experience.

Education and Experience:

• 3–5 years of employee benefits paralegal or similar professional experience required.

• 3–5 years of experience in Health and Welfare benefits consulting with ERISA and Non-ERISA plans.

• 3–5 years of experience in client management related to self-funded plan document creation and management.

• Must have exposure to plan/policy documents, including amendments and SMMs, in prior work environments.

Work Location:

This position is full remote.

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.