Senior Health Plan Pricing Analyst
TriNet
- Location
- Atlanta, GA, United States
- Work model
- On-Site
- Level
- Senior
- Posted
- 5d ago
About this role
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