Utilization Management Auditor Jobs in Michigan (NOW HIRING)

Summary

Responsible for the administration, coordination, auditing, and communication of employee benefit programs including health and welfare plans, retirement programs, leave administration, wellness initiatives, and compliance activities. Ensures all benefit programs and practices comply with applicable federal, state, and local laws and regulations, including multi-state compliance requirements. Partners closely with brokers, carriers, vendors, and internal stakeholders to enhance employee benefits offerings, support wellness initiatives, improve employee engagement, and continuously develop and optimize the organization’s benefits platform and systems. Maintains accurate benefits data within Paylocity and related systems while providing exceptional employee support and maintaining strict confidentiality.

Essential Duties and Responsibilities

• Administer employee benefit programs including medical, dental, vision, life insurance, disability, 401(k), flexible spending accounts (FSA), health savings accounts (HSA), wellness programs, voluntary benefits, and other employee benefit offerings.
• Coordinate benefit enrollments, status changes, qualifying life events, terminations, COBRA administration, and employee communications through Paylocity and vendor platforms.
• Ensure compliance with all applicable federal, state, and local laws and regulations related to employee benefits administration, including ACA, COBRA, HIPAA, ERISA, FMLA, ADA, Section 125, Medicare reporting, and applicable multi-state leave and benefits requirements.
• Maintain strong working knowledge of multi-state employment and benefits compliance requirements, including varying state leave laws, disability programs, paid sick leave laws, and state-specific benefit mandates.
• Administer and monitor leave of absence programs including FMLA, ADA accommodations, paid leave programs, personal leave, short-term disability, long-term disability, workers’ compensation coordination, and state-mandated leave programs.
• Conduct regular audits of benefit enrollments, payroll deductions, dependent eligibility, billing reconciliations, ACA measurement data, and HRIS records to ensure accuracy, compliance, and data integrity.
• Partner closely with benefit brokers, consultants, insurance carriers, and vendors to support benefit strategy, wellness initiatives, compliance updates, plan enhancements, employee engagement, and ongoing benefits platform development.
• Assist in building, enhancing, and maintaining the organization’s benefits platform, employee self-service functionality, system integrations, and benefits administration processes within Paylocity and vendor systems.
• Support the design, implementation, and promotion of employee wellness programs, health initiatives, benefit education campaigns, and employee engagement activities.
• Lead annual open enrollment activities including planning, employee education, benefit communications, system configuration, wellness fairs, enrollment support, and post-enrollment auditing.
• Serve as the primary point of contact for employees regarding benefit eligibility, enrollment, claims issues, leave administration, wellness programs, and policy interpretation.
• Prepare, review, and distribute required benefits notices and compliance documentation including Summary Plan Descriptions (SPDs), COBRA notices, ACA reporting documents, HIPAA notices, and other legally required communications.
• Analyze benefits utilization, enrollment trends, claims data, and plan cost impacts to support organizational decision-making and cost management strategies.
• Assist with the development, forecasting, and monitoring of benefits budgets and related expenses.
• Maintain accurate benefits records, documentation, and record retention practices in accordance with legal and organizational requirements.
• Support internal and external audits related to employee benefits, leave administration, ACA compliance, payroll deductions, and HRIS data.
• Stay current on changes to federal, state, and local employment and benefits laws and proactively recommend process improvements and compliance updates.
• Support onboarding and orientation processes related to employee benefits enrollment, leave programs, and employee education.
• Prepare benefits reports, metrics, analytics, and compliance documentation for management review and regulatory requirements.
• Maintain strict confidentiality of employee medical, benefits, and personal information in compliance with HIPAA and privacy regulations.
• Perform additional duties and special projects as assigned by management.

Qualifications & Skills

• Bachelor’s degree in Human Resources, Business Administration, or related field preferred.
• Minimum of 2–5 years of employee benefits administration experience preferred.
• Experience administering employee benefits programs and HRIS systems, preferably Paylocity.
• Strong knowledge of federal, state, and local benefits laws and regulations including ACA, COBRA, HIPAA, ERISA, FMLA, ADA, Section 125, and multi-state leave and disability requirements.
• Experience managing multi-state benefits compliance and leave administration programs preferred.
• Strong understanding of benefits auditing, payroll deduction reconciliation, ACA reporting, and HRIS data integrity practices.
• Experience working collaboratively with benefit brokers, insurance carriers, wellness vendors, and third-party administrators.
• Excellent communication, employee service, and relationship management skills.
• Strong organizational, analytical, problem-solving, and project management abilities with exceptional attention to detail.
• Proficient in Microsoft Office Suite, particularly Excel.
• Ability to maintain confidentiality and handle sensitive employee information with professionalism and discretion.
• Ability to prioritize tasks, manage multiple projects, meet deadlines, and adapt in a fast-paced environment.
• CEBS, SHRM-CP, PHR, or related certification preferred but not required.

Physical Requirements / Working Conditions

• Fine manipulation using both hands on a moderate basis.
• Typing and computer usage for the work shift.
• Ability to stoop, kneel, crouch, bend, twist, and reach on a moderate basis while working.
• Firm grasping with both hands on a moderate basis.
• Ability to walk and stand for up to half of the workday.
• Ability to work in office, manufacturing environments with varying temperatures and noise levels.

Organizational Culture

• Work safely and follow rules and guidelines for safe work
• Reporting to work on time and with a positive attitude
• Responsible for staying focused on tasks at hand
• Being responsible for work performance and completing tasks throughout the day
• Maintains a good working relationship with co-workers
• Support a positive and steady workflow through the company
• Works with a sense of urgency when needed
• Support, coach or mentor co-workers when needed
• Positively support change throughout the company

*Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.