Plan Builder Specialist

Plan Builder Specialist

*Contract to potential hire position 100% Remote

* Must Have Javelina Experience

A Plan Build Specialist within a third-party administrator (TPA) plays a key role in developing, configuring, and maintaining benefit plans for clients. This individual usually has deep knowledge of plan structures, benefits administration, and system configurations. In the context of TPAs, who manage benefits administration for employers, this role is crucial for ensuring that benefit plans are built, implemented, and maintained accurately within the TPA s systems.
Here s a breakdown of what a senior-level person in this role will do

1. Plan Design and Configuration: This person will configure benefit plans according to client specifications, including eligibility, coverage, and contribution details. They ensure the TPA system accurately reflects the benefits offerings.
2. System Implementation and Testing: They are responsible for testing the plans in the system before going live to confirm they work as intended and meet all compliance standards. This may involve conducting QA (quality assurance) checks or overseeing UAT (user acceptance testing) phases.
3. Client Communication and Support: a plan builder works directly with clients to understand their plan needs and address any issues or customizations required. They help clarify requirements and provide guidance on plan structure.
4. Compliance and Regulatory Knowledge: TPAs need to adhere to federal, state, and sometimes industry-specific regulations (like ERISA, HIPAA, or ACA guidelines). A senior specialist ensures plan configurations align with these regulations.
5. Mentorship and Training: Given their seniority, they may train junior staff on best practices for configuring plans, troubleshooting issues, and following the latest regulatory requirements.

The role combines technical know-how with deep industry expertise to ensure that benefits are accurately managed, compliant, and user-friendly for both the client and their employees.

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.