Sr. Benefits Administration Analyst

Job Description

Job Description

We are a healthcare technology company that provides platforms and solutions to improve the management and access of cost-effective pharmacy benefits. Our technology helps enterprise and partnership clients simplify their businesses and helps consumers save on prescriptions.

As a leader in SaaS technology for healthcare, we offer innovative solutions with integrated intelligence on a single enterprise platform that connects the pharmacy ecosystem. With our expertise and modern, modular platform, our partners use real-time data to transform their business performance and optimize their innovative models in the marketplace.

The Benefits Administration Senior Analyst serves as a senior-level subject matter expert within the Solutions Delivery organization. In this role, the Senior Analyst leads complex client implementations, drives process improvement initiatives, and provides mentorship and technical guidance to junior team members. The Senior Analyst independently owns end-to-end benefit configuration and implementation workstreams for large, complex, or high-priority clients and serves as an escalation point for benefit set-up issues across the team. This role requires deep expertise in pharmacy benefit management, benefit design, and RxSense platform capabilities, along with the ability to influence outcomes across cross-functional teams and directly with clients.

Essential Duties & Responsibilities

Implementation Leadership

• 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.

Benefits Configuration & Technical Expertise

• 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.

Client & Stakeholder Engagement

• 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.

Mentorship & Team Development

• 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.

Process & Operational Excellence

• 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.

Education and/or Experience:

• 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

Salary range: $75,000 - $113,000

RxSense believes that a diverse workforce is a more talented and productive workforce. As such, we are an Equal Opportunity and Affirmative Action employer. Our recruitment process is free from discriminatory hiring practices and all qualified applicants are considered for employment without regard to race, color, religion, sex, gender, sexual orientation, gender identity, ancestry, age, or national origin. Neither will qualified applicants be discriminated against on the basis of disability or protected veteran status. We believe in the strength of the collaboration, creativity and sense of community a diverse workforce brings.