Senior Integrated Accumulations Manager

🕒 Julho 3

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $105.600 - $125.000 / ano

⏰ Tempo Integral

🟠 Sênior

👔 Gerente

👻 Score fantasma 10%

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RxBenefits, Inc.

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

Fundada em 1995

🏥 Saúde

💼 Consultoria

⚕️ Seguro de Saúde

💰 Private Equity Round em 2020-12

Healthcare • Consulting • Healthcare Insurance

A RxBenefits, Inc. é uma empresa especializada em fornecer soluções inovadoras de benefícios farmacêuticos para empregadores e seus funcionários. Eles focam em otimizar a gestão de planos de medicamentos prescritos para reduzir custos e melhorar os resultados de saúde. Por meio de análises avançadas e suporte personalizado aos membros, a RxBenefits visa transformar a experiência de benefícios farmacêuticos para seus clientes.

Descrição

• Develop and execute the accumulations strategy aligned with organizational goals and member experience objectives • Establish roadmaps, priorities, and governance processes for accumulations initiatives • Drive continuous improvement efforts to enhance accuracy, scalability, and operational efficiency • Oversee the design, implementation, and maintenance of integrated accumulations solutions across multiple products and benefit plans • Serve as the subject matter expert for large-scale initiatives involving accumulations modernization, system integrations, and regulatory requirements • Partner with Product, Technology, Operations, and Compliance teams to define requirements and deliver solutions • Ensure successful execution of projects through planning, risk management, stakeholder engagement, and change management • Monitor accumulations performance, accuracy, and reconciliation processes • Identify and resolve complex accumulations issues affecting claims adjudication, member cost-sharing, or provider reimbursement • Establish metrics, KPIs, and reporting frameworks to measure operational effectiveness • Lead root cause analysis and corrective action efforts for accumulations-related incidents • Collaborate with Claims, Benefits Configuration, Enrollment, Finance, Actuarial, and Customer Experience teams • Partner with external vendors and technology partners to ensure seamless data exchange and integration • Serve as the primary business leader for accumulations-related initiatives and enterprise programs • Facilitate executive-level communications and provide regular updates on program status, risks, and outcomes • Ensure accumulations processes comply with applicable federal and state regulations, benefit design requirements, and organizational policies • Support audit activities and maintain documentation for accumulations controls and procedures • Establish governance standards for accumulations configuration, testing, and deployment activities

🎯 Requisitos

• Bachelor's degree in Business, Healthcare Administration, Information Systems, Finance, or related field • Minimum of 8+ years of experience in integrated accumulations, benefits administration, claims processing, or healthcare technology • Minimum of 2+ years of people leadership and team management experience • Deep understanding of healthcare accumulations and related vendor integrations required • Experience leading or serving as the business lead for cross-functional programs and enterprise initiatives • Strong analytical, problem-solving, and decision-making skills • Excellent communication and stakeholder management capabilities • Comfortable analyzing and making sense of large amounts of information to identify key considerations and develop appropriate plans and action as a result • Ability to create and maintain a work environment where others are motivated/inspired to take action and deliver service excellence • Experience working in a fast-paced environment including organizational skills with the proven ability to handle multiple and competing priorities • Excellent written, verbal and presentation skills; able to communicate technical concepts to non-technical personnel.

🏖️ Benefícios

• Remote first work environment • Choice of a HDHP or PPO Medical plan, we pay 100% of the premium for the HDHP for you and your eligible family members • Dental, Vision, Short- and Long-Term Disability, and Group Life Insurance that we also pay 100% of premiums (for your family too on Dental and Vision) • Additional buy-up options for Short- and Long-Term Disability and Life Insurance • 401(k) with an employer match up to 3.5% available after 60 days • Community Service Day to give back and support what you love in your community • 10 company holidays including MLK Day, Juneteenth, and the day after Thanksgiving plus a floating holiday to use as you like • Reimbursements for high-speed internet, we’ll send you a computer and monitors to help you do your best work • Tuition Reimbursement for accredited degree programs • Paid New Parent Leave that can be used for adoption or birth • Pet insurance to protect your furbabies • A robust mental health benefit and EAP service through Spring Health to support you when you need it most