What are the responsibilities and job description for the Benefit Product Specialist position at Texicare?
About Texicare
Founded in 2023 as a mission-driven health affiliate of Texas Mutual, Texicare was created by a group of seasoned healthcare professionals, and is headquartered in Austin, Texas.
Texicare is committed to changing the healthcare landscape by providing small businesses with innovative solutions that increase access to easy-to-use, more affordable, quality health care for Texans and their families. Texicare’s vision is to transform the healthcare ecosystem for the better, helping to create a healthier and happier Texas. Our healthcare plans were designed to be used, to remove barriers to care, to truly make a difference in people’s lives.
We’re looking for passionate, mission-driven individuals to join us in creating a healthier and happier Texas.
About The Role
We are seeking an experienced and detail-oriented Benefit Product Specialist to join our team. This role will be responsible for supporting ongoing work around our health plan portfolio, including but not limited to, working with the claims team to ensure plans are adjudicating claims according to plan intent, and overseeing the plan portfolio renewal process.
In addition to portfolio management, this role will support the development and optimization of foundational product tools and resources that will enhance product management processes across the organization. This includes collaborating on the creation of standardized processes, templates, and tools that streamline product development and improve overall operational efficiency.
The ideal candidate will be proactive, thrive in a cross-functional environment, and be able to manage multiple product lines through the development, market launch, and renewal phases. You will report to the Director, Benefit and Product Development.
In This Role, You Will
Founded in 2023 as a mission-driven health affiliate of Texas Mutual, Texicare was created by a group of seasoned healthcare professionals, and is headquartered in Austin, Texas.
Texicare is committed to changing the healthcare landscape by providing small businesses with innovative solutions that increase access to easy-to-use, more affordable, quality health care for Texans and their families. Texicare’s vision is to transform the healthcare ecosystem for the better, helping to create a healthier and happier Texas. Our healthcare plans were designed to be used, to remove barriers to care, to truly make a difference in people’s lives.
We’re looking for passionate, mission-driven individuals to join us in creating a healthier and happier Texas.
About The Role
We are seeking an experienced and detail-oriented Benefit Product Specialist to join our team. This role will be responsible for supporting ongoing work around our health plan portfolio, including but not limited to, working with the claims team to ensure plans are adjudicating claims according to plan intent, and overseeing the plan portfolio renewal process.
In addition to portfolio management, this role will support the development and optimization of foundational product tools and resources that will enhance product management processes across the organization. This includes collaborating on the creation of standardized processes, templates, and tools that streamline product development and improve overall operational efficiency.
The ideal candidate will be proactive, thrive in a cross-functional environment, and be able to manage multiple product lines through the development, market launch, and renewal phases. You will report to the Director, Benefit and Product Development.
In This Role, You Will
- Perform day-to-day plan portfolio management tasks, including:
- Monitoring plan performance and identifying trends or issues that require action.
- Tracking regulatory changes and ensuring all plans comply with federal and state requirements.
- Maintaining accurate plan documentation, including updates to SBCs, SPDs, and related materials.
- Conducting regular plan reviews to ensure alignment with organizational goals and market demand.
- Coordinating updates or changes to plan designs with internal teams and external vendors.
- Responding to inquiries from internal stakeholders or external partners regarding plan details.
- Work with the claims team to ensure plans are adjudicating claims according to plan intent and maintain consistency across products.
- Support the development of foundational tools, templates, and resources that streamline product processes and enhance operational efficiency.
- Partner with marketing to shape go-to-market strategies, ensuring effective product positioning, messaging, and member communication.
- Conduct market research and competitive analysis to identify opportunities for product differentiation and innovation.
- Collaborate with teams across sales, marketing, operations, and compliance to launch and monitor new products, as well as to support existing product offerings.
- A bachelor’s degree and at least 2 years of experience in health plan product strategy, commercial group health plan administration, or benefit operations within a health plan or related field. If you have 4 years experience in one of these areas, that would be a plus.
- Strong attention to detail, particularly when reviewing regulatory documents and benefit data.
- Familiarity with commercial health insurance products (self-funded, level-funded, and fully insured group), benefit design, and working knowledge of claim coding processes.
- Understanding of SBCs, SPDs, and federal/state health plan regulations, with a focus on compliance.
- Familiarity with mental health parity and how it applies within health plan benefits.
- Experience working cross-functionally with internal teams and managing external vendor relationships.
- Experience supporting or developing foundational tools and processes to improve product development and resource management.
- Strong project management, organizational, and communication skills.
- Proficiency in Microsoft Excel, with the ability to manage and analyze data effectively. Experience with Tableau would be a plus.
- Ability to manage multiple priorities and work effectively in a fast-paced environment.
- Automatic 4% employer contribution to retirement plan
- 401k plan with 100% match up to 6%
- Flexible time off for vacation, illness, etc.
- Nine paid holidays
- Day one health, Rx, vision, and dental insurance
- Life and disability insurance
- Flexible spending account
- Pet coverage and pet Rx discounts
- Free identity theft protection
- Free 2nd medical opinion service
