Senior Integrated Accumulations Manager

🕒 July 3

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RxBenefits, Inc.

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1995

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

💰 Private Equity Round on 2020-12

Healthcare • Consulting • Healthcare Insurance

RxBenefits, Inc. is a company that specializes in providing innovative pharmacy benefits solutions to employers and their employees. They focus on optimizing the management of prescription drug plans to reduce costs and improve health outcomes. Through advanced analytics and personalized member support, RxBenefits aims to transform the pharmacy benefits experience for their clients.

📋 Description

• 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

🎯 Requirements

• 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.

🏖️ Benefits

• 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