Senior Benefits Operations Manager

7 days ago

New York, New York, United States Capital Rx, Inc. Full time
About Capital Rx

Capital Rx is a cutting-edge pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA) driving innovation in the electronic healthcare infrastructure. Our mission is to enhance drug price transparency and improve patient outcomes through our cloud-native enterprise health platform, JUDI.

Job Summary

We are seeking an experienced Senior Benefits Operations Manager to oversee the day-to-day operations of our group benefits programs. This critical role provides excellent customer service, ensures regulatory compliance, and fosters collaboration with vendors.

Key Responsibilities
  • Ensure state and federal regulatory compliance filings, guaranteeing benefits and leave programs adhere to applicable laws.
  • Perform regular financial reviews of benefit carrier billing to verify the accuracy of invoices and enrollment compared to change files, vendor systems, inputs, and payroll.
  • Provide daily benefits support and address inquiries, assisting employees in navigating their benefits needs.
  • Guarantee the accuracy of all benefits enrollments in the HRIS to provide vendors with accurate eligibility information.
  • Assist with new-hire orientations.
  • Conduct quality checks of benefits-related data.
  • Understand self-insured benefits plans and stop loss.
  • Review, validate, and process life status changes.
  • Respond to benefits inquiries from employees on plan provisions, benefits enrollments, status changes, and other general inquiries.
  • Oversee leave-of-absence and disability requests.
  • Effectively interpret FMLA, ADA, and state leave implications as they relate to leaves of absences/disabilities.
  • Assist with the open enrollment process.
  • Provide necessary reports for allocation/billing charges.
  • Document and maintain administrative procedures for assigned benefits processes.
  • Ensure compliance with applicable government regulations.
  • Prepare special reports by collecting, analyzing, and summarizing information and trends.
  • Manage life events benefits processing and approvals.
  • Maintain up-to-date materials for benefits vendors on the 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.
  • Serve as a point of contact for employee inquiries related to benefits, providing clear and concise explanations and solutions.
Requirements
  • Broker/Vendor management exposure and/or experience.
  • Certified Employee Benefit Specialist (CEBS), and Society for Human Resource Management Certified Professional (SHRM-CP) or other related training and certifications is a plus.
  • Effective approaches for choosing a course of action or developing appropriate solutions to issues that arise.
  • Excellent organizational skills, verbal and written communication skills.
  • Excellent time management skills with a proven ability to meet deadlines.
  • Strong analytical, attention to detail, and problem-solving skills.
  • Proficient with Microsoft Office Suite.
  • Proactive issue identification and timely solution delivery.
  • 5+ years of experience in a Benefits administration role.
  • Strong sense of urgency for reaching goals while managing multiple requests concurrently.
  • Strategic, collaborative, and able to thrive in a fast-paced environment.
  • Knowledge of all pertinent federal and state regulations, filing, and compliance requirements affecting employee benefits programs, including the ACA, ERISA, COBRA, FMLA, ADA, Section 125, workers' compensation, and DOL requirements.
  • Bachelor's Degree in Business, Finance, Human Resource Management, or related field OR equivalent, relevant experience in Benefits/Human Resources.
  • Experience with UKG preferred.
  • Able to work effectively with virtual teams.
  • Able to travel 10-15%.
Compensation

The estimated salary range for this position is $100,000 - $110,000 per year, depending on qualifications and experience.

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