The role
This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Benefits Manager based in United States.
As a Benefits Manager, you will own the administration, compliance, and continuous improvement of a comprehensive employee benefits portfolio. You will oversee health, retirement, wellbeing, and ancillary programs while ensuring employees receive accurate, accessible, and reliable support. A major focus of the role is leading the transition from a level-funded or fully insured medical plan to a self-funded model. You will partner closely with Finance, Legal, HR Operations, Payroll, HRIS, brokers, and benefits vendors to manage risk and deliver effective programs. The role combines strategic benefits planning with hands-on administration, analytics, compliance, and process improvement. This is an opportunity to shape benefits operations within a fast-paced, mission-driven healthcare environment.
Accountabilities:
- Own monthly benefits reconciliation across carriers and legal entities, investigating billing discrepancies and resolving eligibility or enrollment issues.
- Maintain data integrity across HRIS, payroll, and carrier systems while documenting root causes and corrective actions for recurring issues.
- Manage the full lifecycle of medical, dental, vision, life, disability, 401(k), and voluntary or ancillary benefits programs.
- Manage ACA compliance, including affordability and eligibility tracking, measurement periods, IRS reporting, and preparation of 1094-C and 1095-C filings.
- Monitor compliance with ERISA, COBRA, HIPAA, PCORI, and applicable state benefits requirements, including annual notices and nondiscrimination testing.
- Lead the end-to-end transition from a level-funded or fully insured medical plan to a self-funded model, including plan design, stop-loss selection, implementation planning, and financial risk management.
- Build and maintain funding and claims exposure models with Finance and monitor claims performance against projections following the transition.
- Manage relationships with brokers, third-party administrators, stop-loss carriers, and other benefits vendors, including renewals, RFPs, negotiations, and service-level accountability.
- Own the complete annual open enrollment process, including strategy, timelines, vendor coordination, system configuration, testing, employee communications, and post-enrollment audits.
- Develop clear benefits education materials and employee communications for clinical and administrative teams.
- Analyze utilization, cost trends, and market benchmarks to identify program improvements and cost efficiencies.
- Partner with HRIS and technology teams on benefits configuration, life-event tracking, integrations, and data feeds.
- Resolve escalated employee benefits inquiries and educate cross-functional teams on plan administration, policy updates, and enrollment changes.
- Develop and maintain SOPs, process documentation, and benefits knowledge resources to support consistency and audit readiness.
Requirements:
- 5–8+ years of progressive employee benefits experience, including direct ownership of comprehensive benefits programs.
- Hands-on experience leading a transition from a level-funded or fully insured medical plan to a self-funded model, including funding design, stop-loss procurement, and financial risk modeling.
- Strong experience managing benefits reconciliation, including carrier billing audits, eligibility discrepancies, and HRIS/payroll/carrier data integrity.
- Deep knowledge of ACA compliance and reporting, including affordability testing, eligibility tracking, measurement periods, and 1094-C/1095-C filings.
- Strong working knowledge of ERISA, COBRA, HIPAA, PCORI, and applicable state benefits requirements.
- Proven experience owning the full open enrollment lifecycle, from planning and vendor coordination through employee communications, system testing, and post-enrollment audits.
- Experience with HRIS platforms such as ADP Workforce Now or similar systems.
- Strong Excel, analytical, and data-management skills with the ability to assess costs, utilization, claims, and program performance.
- Bachelor’s degree or equivalent practical experience.
- Experience supporting multi-entity and/or multi-state benefits programs is preferred.
- Experience in healthcare, clinical, fast-paced, or matrixed organizations is advantageous.
- Experience maintaining benefits knowledge bases and ticketing systems for employee inquiries is a plus.
- CEBS, CBP, or equivalent HR/benefits certification is preferred.
- Strong judgment, communication, organization, and cross-functional collaboration skills, with the ability to independently assess risks and determine when escalation is needed.
Benefits:
- $115,000–$130,000 annual salary.
- Medical, dental, and vision coverage effective from day one.
- 401(k) plan with employer match.
- Generous paid time off and company-paid holidays.
- Paid parental leave.
- Remote work environment.
- Opportunities for professional growth and skill development through a dedicated Learning team.
- Collaborative, fast-paced environment with meaningful opportunities to improve employee benefits operations.
- Strong focus on employee wellbeing and a supportive workplace culture.
How Jobgether works:
We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.
We appreciate your interest and wish you the best!
Why Apply Through Jobgether?
Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.
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