Senior Health Plan Pricing Analyst

TriNet 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.

TriNet 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. TriNet 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.

A Brief Overview
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 TriNet'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 medical insurance underwriting and/or PEO health plan pricing having mastered the nuances of pricing and is a key contributor to the team.

What you will do

• Evaluate employer group risk characteristics, demographic data, claims experience, and supporting documentation to determine appropriate medical pricing and underwriting decisions
• 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
• Analyze census data, benefit plan designs, medical rates, and underwriting information to assess risk exposure and recommend pricing actions
• Review complex cases, including large groups, self-funded plans, and high-risk accounts, to ensure sound pricing decisions.
• Identify trends, inconsistencies, or risk factors that may impact pricing accuracy, profitability, or plan performance
• Collaborate with Revenue, Carrier Partners, and internal stakeholders to communicate pricing requirements, pricing rationale, and risk considerations.
• Assist with process improvements, tool enhancements, training, and mentoring of less experienced underwriting colleagues as required
• Ensure compliance with all carrier partner requirements
• Assist in training of new colleagues and ongoing training of new colleagues
• Performs other duties as assigned
• Complies with all policies and standards

Education Qualifications

• Bachelor's Degree or equivalent experience preferred

Experience Qualifications

• Typically, 5+ years in insurance pricing or underwriting required

Skills and Abilities

• Strong analytical and quantitative skills.

• Knowledge of medical underwriting principles, health plan design, and risk assessment methodologies.
• Ability to interpret complex medical and financial data.
• Advanced Excel and data analysis capabilities.
• Strong written and verbal communication skills.
• Ability to manage multiple priorities and exercise independent judgment.
• 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
• Salesforce.com knowledge is preferred
• Ability to handle multiple tasks and prioritize projects

Travel Requirements
Minimal

Work Environment

• Work in clean, pleasant, and comfortable office or home setting. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable persons with disabilities to perform the essential functions.

The preferred location for this role is Atlanta, GA, and the salary range for this location is $70,800.00 to $132,750.00. All qualified external applicants will be considered for an in-office role, based in Atlanta. All qualified internal candidates are encouraged to apply and consider relocation to Atlanta and may be considered for remote hire at the company’s discretion. The candidate’s final salary offer will be based on the candidate’s skills, education, work location and experience.

A candidate’s compensation may also include bonuses consistent with TriNet’s corporate bonus plan.

Additionally, subject to applicable eligibility requirements, TriNet offers permanent full-time employees a variety of benefits including medical, dental, and vision plans, life and disability insurance, a 401(K) savings plan, an employee stock purchase plan, eleven (11) Company observed holidays, PTO and a comprehensive leave program. Please click the following link for detailed information about our benefits offerings: https://www.trinet.com/documents/blt5b61a1040aae1904

Please Note: TriNet reserves the right to change or modify job duties and assignments at any time. The above job description is not all encompassing. Position functions and qualifications may vary depending on business necessity.

TriNet is an Equal Opportunity Employer and does not discriminate against applicants based on race, religion, color, disability, medical condition, legally protected genetic information, national origin, gender, sexual orientation, marital status, gender identity or expression, sex (including pregnancy, childbirth or related medical conditions), age, veteran status or other legally protected characteristics. Any applicant with a mental or physical disability who requires an accommodation during the application process should contact [email protected] to request such an accommodation.