Benefits Manager

🕒 May 12

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Capital Rx

501 - 1000 employees

Founded 2017

⚕️ Healthcare Insurance

💳 Fintech

🤖 Artificial Intelligence

Healthcare Insurance • Fintech • Artificial Intelligence

Capital Rx is the fastest growing healthtech company in America, dedicated to transforming the prescription pricing and patient care landscape. Founded in 2017, it offers innovative pharmacy benefit management (PBM) services, including customizable pharmacy benefits for large employers and an AI-powered care navigation platform. Capital Rx focuses on delivering cost-effective solutions and operational efficiencies to clients while ensuring transparency and quality care for patients.

📋 Description

• Ensures state and federal regulatory compliance filings and government regulations, ensuring benefits and leave programs adhere to applicable laws. • Performs regular financial reviews of benefit carrier billing to ensure the accuracy of invoices and enrollment compared to change files, vendor systems, inputs, and payroll. • Provide day-to-day benefits support, assisting employees in navigating their benefits needs. • Ensures the accuracy of all benefits enrollments in the HRIS to provide vendors with accurate eligibility information. • Leads new-hire orientation benefit sessions. • Performs quality checks of benefits-related data. • Understands self-insured benefits plans and stop loss. • Manage, review, validate and process life status changes. • Serve as point of contact for benefits inquiries from employees on plan provisions, benefits enrollments, status changes and other general questions. • Oversees leave-of-absence and disability requests. • Effectively interprets FMLA, ADA and state leave implications as they relate to leaves of absences/disabilities. • Manages the open enrollment process. • Provides necessary reports for allocation/billing charges. • Document and maintain administrative procedures for assigned benefits processes. • Prepares special reports by collecting, analyzing and summarizing information and trends. • Maintain up to date materials for benefits vendors on company intranet. • Assist with the maintenance and testing of the HRIS and other systems and with benefits and wellness initiatives. • Conduct regular audits to ensure the accuracy and completeness of benefits data, making necessary corrections and updates. • Stay informed about changes in benefit trends, laws and regulations, ensuring ongoing compliance and timely adjustments to policies. • Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.

🎯 Requirements

• Bachelor’s degree in HR, Business, Finance, or related field (or equivalent experience) • Relevant certifications (e.g., CEBS, SHRM-CP) preferred • 5+ years of benefits administration experience • 5+ years managing leave of absence in a multi-state environment • Strong knowledge of federal/state benefits laws (ACA, ERISA, COBRA, FMLA, ADA, Section 125, Workers’ comp, etc.) • Experience with vendor/broker management • Proficiency in Microsoft Office Suite • Excellent organizational, communication, and time management skills • Proven ability to analyze data, identify issues, and implement solutions independently. • Strong analytical, problem-solving, and detail orientation with ability to manage multiple priorities; Strong sense of urgency for reaching goals • Strategic, collaborative team player able to work in fast-paced, virtual environments; ability to travel (10–15%)

🏖️ Benefits

• Health insurance • 401(k) plan • Remote work options • Paid time off

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