Implementation Specialist

ASO Implementation Specialist

About MotivHealth:

Help us Consumerize Healthcare While Lowering Costs, Providing Better Benefits and Encouraging the Growth of Health Savings

MotivHealth is committed to challenging the status quo. We believe healthcare should be member-focused and delivered in ways that promote transparency, personal choice and financial flexibility. Working with MotivHealth means you’ll be on the cutting edge of healthcare innovation, creativity, and member engagement. To ensure our vision is realized, we maintain a culture that encourages ingenuity, rewards ambition, and inspires collaboration. We are fixated on creating an environment where employees are valued and come prepared to deploy their expertise in ways that support and sustain client success.

About the role:

We are seeking a Health Insurance Implementation Specialist to manage the end-to-end onboarding process for mid-to-large self-funded employer groups. This role is critical in ensuring a seamless transition from sales to active administration by coordinating with clients, brokers, third-party administrators (TPAs), and vendors to implement health insurance plans effectively.

The ideal candidate has experience in self-funded health plans, benefits administration, and project management, ensuring employer groups have a successful and compliant benefits implementation.

Responsibilities and Duties:

• Client Implementation & Onboarding
• Serve as the primary point of contact for self-funded employer groups during implementation.
• Lead kickoff meetings with clients, brokers, and internal stakeholders to outline project scope, milestones, and timelines.
• Gather and validate eligibility, claims, and plan design data to ensure a smooth transition.
• Coordinate with third-party administrators (TPAs), stop-loss carriers, pharmacy benefit managers (PBMs), and other vendors to integrate plan components.
• Conduct benefit mapping and configuration within internal and external systems.
• Monitor implementation progress and resolve roadblocks to ensure timely go-live.
• Plan Design & Configuration
• Translate employer benefits into system configurations, including eligibility rules, contribution structures, and claims administration details.
• Ensure compliance with ERISA, HIPAA, ACA, and other regulatory requirements affecting self-funded plans.
• Conduct plan testing and audits to validate setup accuracy before launch.
• Client & Stakeholder Collaboration
• Work closely with brokers, consultants, and HR teams to provide guidance on self-funded plan setup.
• Partner with internal teams (e.g., underwriting, claims, finance, IT) to ensure alignment on plan details and execution.
• Communicate implementation updates and address client concerns proactively.
• Training & Support
• Educate employer groups on plan administration, reporting, and compliance requirements.
• Provide post-implementation support and transition clients to ongoing account management teams.
• Develop and maintain implementation documentation and best practices.

Required Qualifications and Skills:

• 3-5 years of experience in health insurance implementation, benefits administration, or self-funded plan management.
• Strong knowledge of self-funded health plans, including TPAs, stop-loss, network arrangements, and PBMs.
• Familiarity with ERISA, HIPAA, ACA, COBRA, and other regulatory guidelines governing self-funded insurance.
• Experience managing mid-to-large employer group implementations (500 lives preferred).
• Ability to interpret and configure plan designs in benefits administration or claims processing systems.
• Strong project management skills with experience leading cross-functional teams.
• Excellent communication and problem-solving skills.
• Proficiency in Microsoft Excel, project management tools, and HR/benefits platforms.

Preferred:

• Experience with self-funded claims systems, TPA software, or benefits enrollment platforms.
• Certifications such as CEBS, PMP, or Lean Six Sigma are a plus.
• Background in healthcare consulting, insurance carriers, or third-party administration (TPA) settings.