[Remote] Health Plan Specialist

Remote Full-time
Note: The job is a remote job and is open to candidates in USA. Edison Health Solutions, a Relation Insurance company, is a leading organization in the insurance market, seeking a Health Plan Specialist. This role involves creating and maintaining compliant health plan documentation and ensuring that all materials meet regulatory requirements while collaborating with cross-functional teams. Responsibilities Creates, maintains, and updates PHIA-regulated Summary Plan Descriptions (SPDs) and Plan Documents for ERISA and non-ERISA health plans, ensuring compliance with all applicable regulations Produces Summaries of Benefits and Coverage (SBCs) in accordance with federal and state compliance requirements Manages plan renewals and drafts plan amendments, ensuring accuracy, consistency, and timely delivery across a high-volume document environment Supports the production and delivery of 80+ plan documents per month, adhering to established timelines and quality standards Participates in client implementation meetings to review benefit outlines, clarify plan requirements, and gather all necessary information prior to document creation Collaborates with cross-functional teams (e.g., implementation, compliance, operations) to ensure plan materials are aligned, compliant, and reflective of client expectations Conducts quality reviews to confirm plan documents accurately reflect approved benefit designs and regulatory requirements Maintains organized documentation records and version control in accordance with internal procedures and compliance standards Performs other projects, duties, and tasks, as assigned Skills High School diploma or equivalent Bachelor's degree in Business, Health Administration, Public Policy, English, or related field; equivalent experience preferred Strong writing, editing, and proofreading skills with attention to detail Basic knowledge of employee benefits and health plan concepts (medical, Rx, dental, vision, HSA/HRA/FSA) Working knowledge of the laws and regulations associated with HIPAA Knowledge of and basic understanding of benefit plans & terminology Willingness to adhere to all principles of confidentiality Proficiency with Microsoft Word (templates/styles), Excel, and Adobe Acrobat Ability to manage multiple deadlines in a fast-paced, high-volume environment Excellent communication and collaboration skills A Life Accident and Health License from state of domicile is preferred Certified in Healthcare Compliance (CHC) is helpful Familiarity with plan document generation platforms or template libraries preferred Exposure to ERISA, ACA, HIPAA, COBRA, MHPAEA, and state benefit mandates preferred Familiarity with SBC templates and plan document generation platforms preferred Benefits Family health and wellness programs 401K Employee assistance programs Paid time off Paid holidays Company Overview Despite our size, Relation feels like a family company. Here, a handshake matters. It was founded in 2007, and is headquartered in Walnut Creek, California, USA, with a workforce of 1001-5000 employees. Its website is
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