Senior Plan Building Analyst

Changing Healthcare For Good

At Angle Health, we believe the healthcare system should be accessible, transparent, and easy to navigate. As a digital-first, data-driven health plan, we are replacing legacy systems with modern infrastructure to deliver our members the care they need when they need it. If you want to build the future of healthcare, we'd love for you to join us.

We are excited to grow our Operations team at Angle Health and are looking to bring on a new team member. We’re seeking a highly motivated individual with strong claim plan-building experience who wants to disrupt the health insurance industry. The Senior Plan Building Analyst's responsibilities include leading and overseeing daily operations of claim plan building, managing midyear, new, and renewal plan setup, claim coding updates/alignments, reviewing and updating plans based on regulatory updates, and establishing and enforcing proper plan configuration guidelines, policies, and principles. 

Successful candidates will have a passion for health insurance, superior claim plan-building and analytical skills, bias toward action, and exceptional organizational and communication skills. We move quickly as a team to drive company-wide decisions, thus a balance of getting the details right while still moving fast is important. Finally, we want someone who wants to learn and grow as we’re looking for a candidate who is motivated to advance.

Core Responsibilities

• A successful Plan Building Analyst will ensure a high level of quality and accuracy through plan, benefit, and claim coding configuration while serving as a subject matter expert on benefits and claim adjudication system setup

• Strong ability to autonomously review plan documents and ask clarifying questions both externally and internally, to align plan configuration according to plan guidelines

• Responsible for the accurate review and management of plan benefits coding changes, test execution, and validation efforts of plan benefit design request

• Lead and build out auto-adjudication claim processes with internal teams, always driving for further improvement

• Skilled in leading call discussions with external clients and internal teams to discuss questions and determine the proper course of action

• Possess a strong background in regulatory plan compliance, including knowledge of state and federal laws applicable to fully insured and self-funded ERISA plans and benefit configuration, as well as, but not limited to, HIPAA, the Affordable Care Act (ACA) including No Surprises Act and the Consolidated Appropriations Act, 2021 (CAA)

• Evaluate new business requirements for benefit design changes to establish the appropriate solution

• Create and preserve proper plan and technical documentation to support and validate plan configuration

• Ability to effectively document plan configuration and rules into an easy-to-use Standard Operation Procedure (SOP) and/or plan processing guideline for internal teams to follow

• Actively participates in and contributes to daily communications, team meetings, and project/issue resolution

• Completes deliverables independently and within an agile team setting

• Other duties as assigned

What We Value

• 5+ years of experience in benefit plan configuration/analysis/plan building 

• Strong understanding of claims coding as it relates to plan setup and claims processing

• Strong attention to detail, critical thinking, problem-solving, and analytical skills

• Highly organized and detail-oriented

• Ability to work both independently and within a team as a contributor in a fast-paced, changing environment

• Excellent communication skills, both written and verbal

Bonus Points

• Experienced in building plans within the VBASoftware claims processing system

• Experience working for a startup

• Understanding of electronic claim exchanges and network routing

• Bachelor's degree, or equivalent work experience

The salary range for this job opportunity is $70,000 to $120,000 per year, which is the amount Angle Health anticipates paying for this position at the time of this job posting. The actual base salary offered may differ and will depend on various factors such as geographic location, skills, qualifications, and experience, as well as internal equity.

Because We Value You:

• Competitive compensation and stock options 

• 100% company-paid comprehensive health, vision & dental insurance for you and your dependents 

• Supplemental Life, AD&D and Short-T