Senior Benefit Consultant

• Review and analyze monthly medical, pharmacy, and dental claims data and utilization reports from Horizon BCBSNJ, Prime Therapeutics, and other vendors.
• Produce Commissioners-ready exhibits covering high-cost claimants, inpatient and outpatient utilization, out-of-network leakage, specialty drug and GLP-1 trending, and medical Rx therapy class spend.
• Identify cost drivers and surface actionable recommendations to the Program Manager for discussion with Commissioners and the Fund Administrator.
• Maintain recurring analytics workbooks, dashboards, and trend reports; reconcile data across sources to ensure accuracy before distribution.

• Prepare the monthly Program Manager’s Report to the Fund Commissioners — drafting narrative, building exhibits, integrating pharmacy and network data, and maintaining the established report format.
• Build and refine Excel models and PowerPoint decks for Commissioners’ meetings, vendor evaluations, RFP scoring, and stop-loss renewal discussions.
• Draft professional memoranda, vendor correspondence, and internal summaries with a high standard of clarity and polish.

• Serve as the primary day-to-day point of contact between JBM and the Fund Administrator, responding to service requests, data requests, and ad hoc analyses.
• Coordinate with carriers, brokers, actuaries, underwriters, the PBM, stop-loss partners, and point solution vendors to gather information and resolve issues.
• Attend Trustee and Commissioners’ meetings in a supporting capacity; occasionally present exhibits or data summaries directly to the Commissioners.
• Support the Program Manager in vendor negotiations, RFI/RFP processes, and contract reviews.

• Use AI tools (such as Claude, ChatGPT, Copilot, and others) productively and safely to accelerate document drafting, data summarization, research, and analytical workflows — always with appropriate review for accuracy and confidentiality.
• Contribute to the continuous improvement of JBM’s reporting templates, data pipelines, and analytical processes as the Fund scales.
• Maintain strict confidentiality of Fund, member, and vendor information in compliance with HIPAA and the firm’s information security practices.

• Bachelor’s degree, or equivalent professional experience.
• Three to five years of relevant experience in health insurance, employee benefits consulting, benefits brokerage, third-party administrator, or carrier account management environment.
• Strong working knowledge of medical and pharmacy claims data, high-cost claimant analysis, network utilization metrics, and common cost containment levers.
• Advanced Microsoft Excel skills — comfortable with pivot tables, large data sets, formula-driven models, and clean formatting.
• Strong Microsoft PowerPoint skills, with the ability to build clean, professional client-ready decks.
• Excellent written communication — able to produce polished memoranda, board-level reports, and clear vendor correspondence.
• Demonstrated comfort and proficiency using modern AI tools as part of daily workflow.
• Strong interpersonal skills — able to communicate with Commissioners, senior vendor executives, and internal team members with professionalism and discretion.
• High level of accuracy, attention to detail, and ownership of deliverables. Life and Health producer license (or willingness to obtain within first 12 months).

• Prior experience supporting or consulting to New Jersey employers, Joint Health Insurance Fund (JHIF), or other public-sector self-insured entities.
• Familiarity with Horizon BCBSNJ reporting, Prime Therapeutics (or comparable PBM) reporting, and health intelligence/claims analytics platforms (e.g., Innovu, Springbuk, Artemis).

• Base Salary: TBD
• Bonus: TBD
• Equity: Future equity participation opportunity for the right candidate as the firm and Fund engagement continue to grow.
• Benefits: Standard employer-sponsored benefits package (details provided during offer stage).
• Schedule: Hybrid schedule — three (3) days per week in the Bordentown, NJ office (Burlington County); two (2) days remote.

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