Benefits Manager

You will own:

Benefits Reconciliation & Administration

• Own monthly benefits reconciliation across all carriers and both legal entities; identify, research, and resolve billing discrepancies.
• Maintain data integrity between HRIS, payroll, and carrier systems; document root causes and corrective actions for recurring issues.
• Manage full ownership of benefits programs: medical, dental, vision, life, disability, 401(k), and voluntary/ancillary offerings.

ACA & Compliance

• Manage ACA compliance end to end, including monthly affordability and eligibility tracking, measurement period administration, and IRS reporting.
• Prepare and file 1094-C/1095-C forms; respond to IRS notices and manage penalty risk.
• Ensure ongoing compliance with ERISA, COBRA, HIPAA, PCORI, and applicable state benefits mandates across both entities, including required annual notices and non-discrimination testing.

Self Funded Transition & Plan Strategy

• Lead the end to end transition from level funded or fully insured to self funded medical plans, including plan design, stop loss selection, and implementation timeline.
• Build and maintain funding and claims exposure models in partnership with Finance; monitor claims experience against projections post-transition.
• Serve as the primary point of contact with brokers, TPAs, and stop loss carriers on renewals, plan design, and performance.

Open Enrollment

• Own the full open enrollment cycle: strategy, timeline, vendor coordination, system configuration, and testing.
• Develop clear, plain language employee communications and education sessions for a clinical and administrative workforce.
• Lead post-OE audit and reconciliation to confirm elections, deductions, and carrier feeds are accurate before go-live.

Analytics & Vendor Management

• Analyze benefit utilization, cost trends, and market benchmarking data to recommend program enhancements and cost efficiencies.
• Manage broker and carrier relationships, including renewal negotiations, RFPs, and service level accountability.
• Partner with HRIS/technology teams on benefits configuration, life event tracking, and vendor data integrations.
• Manage escalated benefits inquiries and educate cross-functional teams on plan administration, OE changes, and policy updates.
• Partner cross-functionally with Payroll, HRIS, Legal, and Finance; escalate appropriately based on complexity or risk, using independent judgment on when support is needed.
• Build and maintain SOPs and process documentation for benefits operations to support consistency and audit readiness.

You have:

• Minimum
• 5 to 8+ years of progressive employee benefits experience, including direct plan ownership (P3/P4 scope).
• Strong working knowledge of ACA reporting, ERISA, COBRA, HIPAA, and PCORI requirements.
• HRIS experience (ADP Workforce Now or similar) and strong Excel/analytical skills.
• Bachelor's degree or equivalent experience.

Must have:

• Direct, hands-on experience leading a transition from a level funded or fully insured medical plan to self funded, including funding arrangement design, stop loss procurement, and financial risk modeling.
• Proven ownership of benefits reconciliation: monthly carrier billing audits, eligibility discrepancies, and payroll/HRIS/carrier data integrity.
• Deep benefits compliance and ACA management and reporting experience: affordability testing, eligibility tracking, and 1094-C/1095-C filing.
• Full lifecycle open enrollment ownership, from strategy and vendor coordination through employee communications and post-OE audit.

Preferred

• Multi-entity and/or multi-state benefits administration experience.
• Experience supporting benefits in a fast-paced healthcare, clinical, or matrixed organization.
• Experience maintaining a benefits knowledge base and ticketing system for employee inquiries.
• CEBS, CBP, or equivalent HR/benefits certification.