The Senior Integrated Accumulations Manager is responsible for leading the strategy, design, implementation, and optimization of enterprise-wide accumulations capabilities that support benefit administration, claims processing, member experience, and regulatory compliance. This role serves as a critical bridge between business, product, operations, technology, and external accumulations vendors to ensure accurate tracking and management of member accumulations, including deductibles, out-of-pocket maximums, benefit limits, and other financial balances across integrated healthcare ecosystems.
The ideal candidate combines deep healthcare payer knowledge, strong program leadership skills, and expertise in accumulations platforms, benefits configuration, claims adjudication, and cross-functional stakeholder management.
Essential Job Responsibilities Include:
- Strategy & Leadership
- 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.
- Product & Program Management
- 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.
- Operational Excellence
- 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.
- Cross-Functional Collaboration
- 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.
- Compliance & Governance
- 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.
Required Skills / Experience:
- 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.
Based on relevant market data and other factors, the anticipated hiring range for this role is $105,600 to $125,000 annually. Final compensation rates will be determined based on various factors, including but not limited to experience, skills, knowledge, and internal equity considerations. This role is also short-term incentive eligible. Incentive amounts will vary by individual and business goals.
We are committed to fair and equitable compensation practices. The final salary offered to the selected candidate may vary from the posted range due to individual qualifications. Our goal is to ensure that all teammates are compensated fairly and competitively based on their contributions to our organization.
RxBenefits is also committed to providing best in class benefits to our teammates. We offer a robust total rewards package that includes:
- 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
Skills Required
- Bachelor's degree in Business, Healthcare Administration, Information Systems, Finance, or a related field
- 8+ years of experience in integrated accumulations, benefits administration, claims processing, or healthcare technology
- 2+ years of people leadership and team management experience
- Deep understanding of healthcare accumulations and related vendor integrations
- 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
- Ability to analyze large amounts of information, identify key considerations, and develop appropriate action plans
- Ability to create and maintain a work environment that motivates others to deliver service excellence
- Organizational skills and ability to manage multiple competing priorities in a fast-paced environment
- Excellent written, verbal, and presentation skills, including the ability to communicate technical concepts to non-technical personnel
What We Do
Founded in 1995 and headquartered in Birmingham, AL with an office in Towson, MD, RxBenefits is the employee benefit industry’s first and only technology-enabled pharmacy benefits optimizer (PBO). Today, we employ more than 700 pharmacy pricing, data, and clinical experts to deliver prescription benefit savings to employee benefit consultants and their self-funded clients. RxBenefits exists to ensure EBC’s can offer mid-sized employers and their members an affordable pharmacy benefit solution combined with a Fortune 100 service experience. Our unique approach is enabled by our market-leading purchasing power, independent clinical solutions and high-touch superior service, allowing our clients to achieve their pharmacy program objectives. RxBenefits’ unwavering commitment to keeping pharmacy benefits affordable has created a better solution for the ever-changing market. RxBenefits provides equal opportunities for everyone that works for us and everyone that applies to join our team, without regard to sex or gender, gender identity, gender expression, age, race, religious creed, color, national origin, ancestry, pregnancy, physical or mental disability, medical condition, genetic information, marital status, sexual orientation, any service, past, present, or future, in the uniformed services of the United States (military or veteran status), or any other consideration protected by federal, state, or local law.
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