Senior Consultant, Health & Welfare Benefits (Remote)

• Independently manages multiple client engagements and owns defined workstreams from start to finish.
• Develops client-ready analyses, insights, and deliverables across health and welfare strategies, including medical, pharmacy, wellbeing, and point solutions.
• Develops and monitors engagement work plans, timelines, and milestones; proactively identifies risks, dependencies, or scope changes and escalates as appropriate to project and practice leadership to support on-time, high-quality delivery.
• Collaborates with internal project teams, subcontractors, and external partners, coordinating closely with senior leaders to ensure effective execution of assigned projects.
• Maintains organized project documentation, data files, and work products.
• Prepares materials and presents findings to client teams with clarity and confidence, alongside and with review from senior leadership.
• Partners with leadership to ensure recommendations are practical, data-driven, and aligned with client objectives and PBGH advisory principles.
• Translates key findings into externally facing white papers, briefs, and presentations, with senior leadership input, to advance collective impact.

• Analyzes employer demographics, claims, utilization, cost, quality, and performance data, including self-funded medical and pharmacy claims.
• Leads financial evaluations, including pricing, budgeting, forecasting, premium-equivalent rate setting, contribution modeling and working knowledge in IBNR and stop-loss.

• Applies analytical tools, methodologies and comprehensive health and welfare benefits knowledge to assess plan performance, vendor effectiveness, cost drivers, and improvement opportunities, aligning findings with PBGH advisory principles.
• Supports development and application of analytic solutions leveraging emerging datasets (e.g., Transparency in Coverage, Hospital Price Transparency).
• Translates complex data into clear narratives, executive summaries, and actionable insights for employer audiences, incorporating feedback from senior leadership as appropriate.
• Contributes to standardized tools, templates, and methodologies to support scalable consulting delivery.

• Creates and documents methodologies, analyses, and insights to ensure rigor, consistency and alignment with PBGH advisory principles.
• Stays current on market trends, regulatory developments, and innovations across the health benefits landscape, sharing relevant implications with leadership and colleagues.
• Creates resources and tools that build knowledge base for continued intellectual capital development.
• Shares learnings and best practices with colleagues to continuously improve service delivery.

• Has deep knowledge of the health care market ecosystem and well-established relationships with vendors, including carriers, TPAs, data platforms, data warehouses, and point solution vendors.
• Manages the RFP/RFI process, including drafting questionnaires, interfacing vendors, evaluating proposals and responses, preparing and presenting results and recommendations to employers, and conducting vendor/finalist interviews, with input and oversight from senior leadership.

• Possesses fundamental knowledge of health and welfare program compliance and regulations, including but not limited to, ERISA, ACA, CAA, HIPAA, COBRA, Section 125, and MHPAEA.
• Applies analytical rigor to conduct reviews of plan fiduciary and health plan compliance, contracts and agreements, identify potential risks and liabilities, and develop and implement strategic corrective action plans to address non-compliance issues.
• Demonstrates track record of self-directed professional development and a commitment to staying current in a rapidly changing legal landscape and utilizing legal and industry research tools (e.g., Bloomberg Law, Federal Register, National Conference of State Legislatures) to independently resolve complex compliance inquiries.
• Contributes to internal knowledge base or advisory service offerings regarding new regulatory trends.

• Supports prospecting efforts and proposal development, including drafting scopes, workplans, timelines, and fee estimates.
• Assists with responses to RFPs, RFIs, and grant-funded opportunities as needed.
• Participates in client relationship development through excellent service delivery and responsiveness.
• Identifies opportunities for follow-on work and flags potential expansion areas.
• Supports technical learning opportunities for members.
• Tracks activity with current and potential clients in Asana and Salesforce. 

• Bachelor’s degree required.
• A minimum of 8+ years of experience in a consulting or similar environment advising large/jumbo employers on health and welfare benefits.
• Demonstrated ability to solve Fortune 500 companies’ complex health and benefits issues.
• Strong working knowledge of the health benefits ecosystem, including carriers, PBMs, point solutions, and consulting/brokerage models.
• Demonstrated experience analyzing employer medical and pharmacy claims data and translating results into client-ready insights.
• Solid technical expertise across health and welfare topics, such as financial and actuarial concepts, plan design, vendor evaluation, compliance (e.g., ERISA, CAA), pharmacy and PBM strategies, mental health, wellbeing, and emerging solutions.
• Proven ability to manage multiple workstreams and adapt to shifting priorities in a fast-paced environment.
• Strong written and verbal communication skills, with experience developing polished PowerPoint presentations and executive summaries.
• Mastery of Microsoft Office Suite
• Highly organized, detail-oriented, and proactive.
• Ability to travel approximately 10–15%.
• Life & Health Insurance License

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