Benefits Administrator Lead

Location: Remote (For Non-Local) or Hybrid (Local to NYC area)

Position Summary:

The benefits administrator position is responsible for the day-to-day operations of the Capital Rx group benefits programs. This position provides excellent customer service, assists with benefit and claims navigation and works directly with vendors. The administrator continually investigates new benefits programs, improves existing programs, and supervises and monitors benefits administration.

Position Responsibilities:

• Ensures state and federal regulatory compliance filings, ensuring benefits and leave programs adhere to applicable laws
• Performs regular financial reviews of benefit carrier billing to ensure the accuracy of invoices and enrollment compared to change files, vendor systems, inputs, and payroll.
• Provide day-to-day benefits support and address inquiries, assisting employees in navigating their benefits needs.
• Ensures the accuracy of all benefits enrollments in the HRIS to provide vendors with accurate eligibility information.
• Assists with new-hire orientations.
• Performs quality checks of benefits-related data.
• Understands self-insured benefits plans and stop loss.
• Reviews, validates and processes life status changes.
• Responds to benefits inquiries from employees on plan provisions, benefits enrollments, status changes and other general inquiries.
• Oversees leave-of-absence and disability requests.
• Effectively interprets FMLA, ADA and state leave implications as they relate to leaves of absences/disabilities.
• Assists with the open enrollment process.
• Provides necessary reports for allocation/billing charges.
• Document and maintain administrative procedures for assigned benefits processes.
• Ensure compliance with applicable government regulations.
• Prepares 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 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.
• Stay informed about changes in benefit trends, laws and regulations, ensuring ongoing compliance and timely adjustments to policies.
• Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance.

Minimum Qualifications:

• 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.
• Uses effective approaches for choosing a course of action or develops 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.
• Proactively identify issues and deliver timely solutions
• 5+ years of experience in a Benefits administration role
• Strong sense of urgency for reaching goals while managing multiple requests concurrently
• Strategic, collaborative, and can 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.
• Ability to work effectively with virtual teams
• Ability to travel 10-15%

Base Salary: $100,000 - $110,000

Nothing in this position description restricts management's right to assign or reassign duties and responsibilities to this job at any time.

About Capital Rx

Capital Rx is a full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA), advancing our nation's electronic healthcare infrastructure to improve drug price visibility and patient outcomes. As a Certified B Corp, Capital Rx is executing its mission through the deployment of JUDI, the company's cloud-native enterprise health platform, and a Single-Ledger Model, which increases visibility and reduces variability in drug prices. JUDI connects every aspect of the pharmacy ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of pharmacy benefits and rebuilding trust in healthcare.

Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.