Advanced Technologies. Powerful Results.
Senior Benefits Administration Analyst
Location
United States
Posted
5 days ago
Salary
$75K - $113K / year
Seniority
Senior
Job Description
Senior Benefits Administration Analyst
RxSense
• Own and lead the full implementation lifecycle for large, complex, or strategic clients from initiation through production deployment, ensuring all contractual deliverables are met on time and within scope. • Serve as the primary benefits configuration expert on client implementations, leading all discovery, requirements gathering, and configuration sessions. • Anticipate and proactively mitigate implementation risks; develop contingency plans and communicate issues to leadership with recommended solutions. • Review and validate benefit set-ups performed by junior analysts prior to client go-live. • Configure and maintain complex benefit designs, clinical rules, pharmacy networks, pricing structures, accumulators, and hierarchies across the RxSense platform. • Develop deep expertise in RxSense claims platforms and serve as an internal resource for platform capabilities and limitations. • Lead root-cause analysis on complex benefit set-up issues; develop and implement process changes to prevent recurrence. • Conduct impact analysis for platform changes, client requests, and identified issues affecting benefit configurations. • Build and sustain trusted advisor relationships with clients, serving as a consultative partner on benefit design strategy and platform optimization. • Represent Benefits Administration in cross-functional meetings, client steering committees, and escalation calls. • Partner with Client Services, Pharmacy Networks, UAT/QA, IT, Finance, and Clinical teams to drive flawless implementations and ongoing client satisfaction. • Provide mentorship, training, and day-to-day guidance to Benefits Administration Analysts and other team members. • Develop and deliver training materials for internal staff and private-label clients on benefit set-up requirements and platform best practices. • Act as an escalation point for the team on complex or ambiguous benefit configuration challenges. • Identify and lead initiatives to improve departmental workflows, documentation, and quality standards. • Assist the Director in developing and maintaining department policies, procedures, and best practices. • Contribute to strategic projects and product initiatives as a subject matter expert.
Job Requirements
- Bachelor's degree or equivalent experience in healthcare, pharmacy benefit management (PBM), or a related field
- 5+ years of experience in pharmacy benefit management, client implementations, or plan builds, with at least 2 years in a senior or lead capacity
- Experience with PBM claims processing platforms required; RxSense platform experience strongly preferred
- Prior experience in a consultative client-facing role strongly preferred
Benefits
- RxSense believes in a diverse workforce
- Equal Opportunity and Affirmative Action employer
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