Plan Benefits Analyst in Sacramento, California at Western Health Advantage

Plan Benefits Analyst

Department: Systems Contract
Location: Sacramento (Onsite/Hybrid)
Schedule: Full-Time | Exempt
Compensation: $70,304 to $77,000 annually
Travel: Minimal, as needed

If you’re the kind of person who loves turning complexity into clarity, spotting inconsistencies before anyone else does, and making systems run like a well-oiled machine—this role is built for you.

At Western Health Advantage, our Plan Benefits Analysts are the behind-the-scenes architects ensuring our benefit plans are accurate, compliant, and seamlessly delivered to members. You’ll be part analyst, part problem-solver, and part project manager—owning critical processes that directly impact the member experience.

Plan Analysis and Configuration

• Evaluate system capabilities and support the rollout of new or updated benefit plans
• Lead benefit configuration projects with internal teams and external vendors
• Identify opportunities to improve accuracy and efficiency through automation

Systems Ownership and Quality Assurance

• Manage key systems such as Central Benefits Driver (CBD) and Master Health Plan (MHP)
• Perform audits, testing, and validation to ensure data accuracy and compliance
• Troubleshoot configuration and data-related issues

Subject Matter Expertise and Support

• Serve as the primary resource for benefit design and configuration questions
• Provide documentation, insights, and guidance to internal stakeholders
• Support front-line teams with clear and accurate information

Cross-Functional Collaboration and Compliance

• Partner with IT, Compliance, Legal, Marketing, and vendors
• Support regulatory filings (e.g., SERFF, QHP, CalHEERS)
• Contribute to member-facing materials such as Welcome Kits and Summary of Benefits

Project and Process Management

• Coordinate incoming work requests and manage priorities
• Track deliverables and ensure timely implementation of benefit changes
• Maintain documentation for systems, processes, and updates

Education & Experience

• Bachelor’s degree (preferred)
• ~2+ years in benefits administration or a related field

Technical & Industry Knowledge

• Understanding of medical and pharmacy benefit structures
• Familiarity with healthcare systems and regulations
• Experience with Facets (a plus)

Tools & Skills

• Strong analytical skills (Excel, Access, Word required; Smartsheet a plus)
• Exceptional attention to detail in a highly regulated environment
• Ability to manage multiple priorities and meet deadlines

Core Strengths

• Critical thinking and problem-solving
• Clear communication and collaboration
• Ownership mindset with a focus on quality and accuracy

Western Health Advantage is committed to providing equal employment opportunities to employees and applicants for employment on the basis of merit and without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, physical or mental disability, medical condition, genetic information, marital status, ancestry, military or veteran status, or any other basis made unlawful by federal or state law.

Western Health Advantage values and supports the unique talents and strengths that each employee brings to our organization. Collaborating with the best and the brightest means a dynamic, fulfilling work experience for you — and excellent customer service for our members.

To apply, email cover letter and resume to hr@westernhealth.com EOE

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