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Supports new and existing health insurance accounts by partnering with Sales, brokers, and internal teams. Responsibilities include resolving complex service issues, administering enrollment and account documentation, coordinating group implementations and renewals, maintaining account records, validating information, supporting retention and growth, and identifying process improvements. The role requires health insurance experience, strong customer and stakeholder relationship skills, Microsoft Office proficiency, and a New Jersey health and life insurance license or ability to obtain one.

Support premium rate development and pricing for large group, individual, and small group markets. Perform pricing analyses, financial modeling, experience studies, regulatory and Mental Health Parity reviews, and rate filings. Collaborate with actuarial, product, finance, and regulatory teams to analyze data, assess legislative impacts, and produce reports and recommendations to support pricing strategy and regulatory compliance.

Support actuarial and data analytics for risk-adjusted lines (ACA, Medicare Advantage, Medicaid). Analyze risk scores, financial impacts, and performance metrics; produce projections (CMS-HCC, HHS-HCC), inform risk adjustment strategy, reporting, pricing, and forecasts; evaluate vendor performance and intervention ROI; support ACA pricing and MA bid submissions.

Manages complex national large-group health insurance accounts, focusing on retention, renewals, contract negotiations, product expansion, client relationships, service performance, and issue resolution. Advises clients, brokers, trustees, and consultants; coordinates with internal teams and vendors; delivers reporting, workshops, and regulatory updates; and makes financial, operational, and service-related decisions. The role requires national travel, strong negotiation and presentation skills, health insurance knowledge, and a New Jersey Health/Life license.

Performs actuarial pricing, underwriting support, reserving, forecasting, trend analysis, and risk assessment for Stop Loss and Level Funded products. Develops and supports pricing models, analyzes financial and utilization data including IBNR, contributes to business planning, and communicates actuarial findings to business partners. The role supports new business and renewal decisions while identifying opportunities and minimizing financial risk.

Manage and retain public-market accounts by handling contract renewals, negotiating terms, selling additional product lines, and developing new business. Provide client workshops on enrollment and claims, advise on regulatory impacts, modify contracts as needed, and make binding financial and service decisions. Requires travel across New Jersey and coordination with stakeholders.

Lead design, development and enhancement of health insurance products across market segments. Serve as product SME, conduct market/research/competitive analysis, monitor product performance and profitability, support cross-functional teams (Sales, Underwriting, Actuarial, IT), manage product lifecycle and maintenance, present Consumerism products, and drive sales, utilization and retention plans.

Lead and supervise assigned internal audits and initiatives: develop scope and work programs, perform testing and analysis, document control issues, prepare reports, track remediation, and mentor staff while collaborating with management to improve internal controls.

Draft, review, negotiate, and manage commercial, vendor, finance, real estate, and Business Associate Agreements. Develop templates and contract tools, advise stakeholders on legal risks, train colleagues on contract best practices, report on BAA performance, support privacy incident response and data ethics, and recommend operational efficiencies.

Lead IT Auditor who supervises and executes IT audit programs, develops audit scope/workpapers, tests SOX 404 controls, documents findings, coordinates external audits, coaches staff, and recommends control improvements.