Human Resources-Benefits Manager
About The Position
Manages and oversees the administration, compliance, and strategic management of employee benefits program, with a strong emphasis on self-funded health insurance plans. This position will serve as the primary liaison between the organization, insurance broker, Third-Party Administrator (TPA), stop-loss carrier, pharmacy benefit manager (PBM) and other benefits vendors, regulatory compliance, and healthcare cost management. Support executive leadership by providing data analysis, recommendations, that align with organizational goals and employee needs. Partner with brokers, TPA’s, stop-loss carriers, and PBMs to administer and optimize plan performance. Review and analyze claims utilization reports, pharmacy spend, and trend data. Monitor stop-loss coverage large claim activity, and renewal projections.
Requirements
- Bachelor’s degree in human resources, Business Administration, Healthcare Administration, Insurance, or related field.
- 5 years of progressive benefits administration experience.
- Minimum 3 years of experience working with self-funded health plans.
- Strong knowledge of employee benefits regulations and compliance requirements.
- Experience working directly with brokers, TPAs, Insurance carriers and PBMs.
- Advance proficiency in Microsoft Excel and reporting tools.
Responsibilities
- Manages and oversees the administration, compliance, and strategic management of employee benefits program.
- Serves as the primary liaison between the organization, insurance broker, Third-Party Administrator (TPA), stop-loss carrier, pharmacy benefit manager (PBM) and other benefits vendors.
- Ensures regulatory compliance and healthcare cost management.
- Supports executive leadership by providing data analysis and recommendations.
- Partners with brokers, TPAs, stop-loss carriers, and PBMs to administer and optimize plan performance.
- Reviews and analyzes claims utilization reports, pharmacy spend, and trend data.
- Monitors stop-loss coverage large claim activity and renewal projections.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
