Leads enterprise accumulations strategy, implementation, optimization, governance, and vendor integrations supporting healthcare benefits, claims, member cost-sharing, and regulatory compliance. Partners across product, technology, operations, claims, benefits, finance, actuarial, and compliance teams. Oversees roadmaps, requirements, performance monitoring, reconciliation, issue resolution, root-cause analysis, reporting, audits, and change management while serving as the primary business leader for enterprise initiatives.
The Senior Integrated Accumulations Manager is responsible for leading the strategy, design, implementation, and optimization of enterprise-wide accumulations capabilities that support benefit administration, claims processing, member experience, and regulatory compliance. This role serves as a critical bridge between business, product, operations, technology, and external accumulations vendors to ensure accurate tracking and management of member accumulations, including deductibles, out-of-pocket maximums, benefit limits, and other financial balances across integrated healthcare ecosystems.
The ideal candidate combines deep healthcare payer knowledge, strong program leadership skills, and expertise in accumulations platforms, benefits configuration, claims adjudication, and cross-functional stakeholder management.
Essential Job Responsibilities Include:
- Strategy & Leadership
- Develop and execute the accumulations strategy aligned with organizational goals and member experience objectives.
- Establish roadmaps, priorities, and governance processes for accumulations initiatives.
- Drive continuous improvement efforts to enhance accuracy, scalability, and operational efficiency.
- Product & Program Management
- Oversee the design, implementation, and maintenance of integrated accumulations solutions across multiple products and benefit plans.
- Serve as the subject matter expert for large-scale initiatives involving accumulations modernization, system integrations, and regulatory requirements.
- Partner with Product, Technology, Operations, and Compliance teams to define requirements and deliver solutions.
- Ensure successful execution of projects through planning, risk management, stakeholder engagement, and change management.
- Operational Excellence
- Monitor accumulations performance, accuracy, and reconciliation processes.
- Identify and resolve complex accumulations issues affecting claims adjudication, member cost-sharing, or provider reimbursement.
- Establish metrics, KPIs, and reporting frameworks to measure operational effectiveness.
- Lead root cause analysis and corrective action efforts for accumulations-related incidents.
- Cross-Functional Collaboration
- Collaborate with Claims, Benefits Configuration, Enrollment, Finance, Actuarial, and Customer Experience teams.
- Partner with external vendors and technology partners to ensure seamless data exchange and integration.
- Serve as the primary business leader for accumulations-related initiatives and enterprise programs.
- Facilitate executive-level communications and provide regular updates on program status, risks, and outcomes.
- Compliance & Governance
- Ensure accumulations processes comply with applicable federal and state regulations, benefit design requirements, and organizational policies.
- Support audit activities and maintain documentation for accumulations controls and procedures.
- Establish governance standards for accumulations configuration, testing, and deployment activities.
Required Skills / Experience:
- Bachelor's degree in Business, Healthcare Administration, Information Systems, Finance, or related field.
- Minimum of 8+ years of experience in integrated accumulations, benefits administration, claims processing, or healthcare technology.
- Minimum of 2+ years of people leadership and team management experience.
- Deep understanding of healthcare accumulations and related vendor integrations required.
- Experience leading or serving as the business lead for cross-functional programs and enterprise initiatives.
- Strong analytical, problem-solving, and decision-making skills.
- Excellent communication and stakeholder management capabilities.
- Comfortable analyzing and making sense of large amounts of information to identify key considerations and develop appropriate plans and action as a result.
- Ability to create and maintain a work environment where others are motivated/inspired to take action and deliver service excellence.
- Experience working in a fast-paced environment including organizational skills with the proven ability to handle multiple and competing priorities.
- Excellent written, verbal and presentation skills; able to communicate technical concepts to non-technical personnel.
Based on relevant market data and other factors, the anticipated hiring range for this role is $105,600 to $125,000 annually. Final compensation rates will be determined based on various factors, including but not limited to experience, skills, knowledge, and internal equity considerations. This role is also short-term incentive eligible. Incentive amounts will vary by individual and business goals.
We are committed to fair and equitable compensation practices. The final salary offered to the selected candidate may vary from the posted range due to individual qualifications. Our goal is to ensure that all teammates are compensated fairly and competitively based on their contributions to our organization.
RxBenefits is also committed to providing best in class benefits to our teammates. We offer a robust total rewards package that includes:
- Remote first work environment
- Choice of a HDHP or PPO Medical plan, we pay 100% of the premium for the HDHP for you and your eligible family members
- Dental, Vision, Short- and Long-Term Disability, and Group Life Insurance that we also pay 100% of premiums (for your family too on Dental and Vision)
- Additional buy-up options for Short- and Long-Term Disability and Life Insurance
- 401(k) with an employer match up to 3.5% available after 60 days
- Community Service Day to give back and support what you love in your community
- 10 company holidays including MLK Day, Juneteenth, and the day after Thanksgiving plus a floating holiday to use as you like
- Reimbursements for high-speed internet, we’ll send you a computer and monitors to help you do your best work
- Tuition Reimbursement for accredited degree programs
- Paid New Parent Leave that can be used for adoption or birth
- Pet insurance to protect your furbabies
- A robust mental health benefit and EAP service through Spring Health to support you when you need it most
Similar Jobs
Fintech • HR Tech
Own CX data infrastructure, including pipelines, data models, governance, monitoring systems, and Streamlit dashboards. Apply advanced statistics and AI-assisted anomaly detection to identify customer experience opportunities and performance issues. Partner with CX leaders, data science, engineering, and Salesforce teams to define metrics, answer causal questions, and guide operational decisions. Establish data quality standards, validate AI-generated outputs, communicate insights clearly, and mentor data practitioners.
Top Skills:
DatabricksDbtPythonSalesforceSnowflakeSQLStreamlit
.png)
Consumer Web • eCommerce • Machine Learning • Software • Sports • Analytics
Manage marketplace business operations and day-to-day functions while delivering strategic transformation projects. Build scalable systems to replace manual processes, establish operational rigor across teams, oversee billing and fulfillment programs for key accounts, and use AI to automate workflows. The role requires strong organization, analytical problem-solving, project management, communication, and cross-functional collaboration skills.
Top Skills:
AI
Artificial Intelligence • Consumer Web • Logistics
Owns JunkRabbit’s end-to-end customer experience and operating systems. Responsibilities include improving intake, quoting, booking, issue resolution, and service metrics; designing workflows, automation, tooling, and SOPs; acquiring, onboarding, and retaining independent haulers; and leading market launches. The COO will personally handle customer calls, scope complex jobs, onboard partners, analyze operating metrics, and collaborate with engineering and investors in a fast-growing startup environment.
Top Skills:
AIAutomationDynamic Pricing SystemsInternal Tooling
What you need to know about the Chicago Tech Scene
With vibrant neighborhoods, great food and more affordable housing than either coast, Chicago might be the most liveable major tech hub. It is the birthplace of modern commodities and futures trading, a national hub for logistics and commerce, and home to the American Medical Association and the American Bar Association. This diverse blend of industry influences has helped Chicago emerge as a major player in verticals like fintech, biotechnology, legal tech, e-commerce and logistics technology. It’s also a major hiring center for tech companies on both coasts.
Key Facts About Chicago Tech
- Number of Tech Workers: 245,800; 5.2% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: McDonald’s, John Deere, Boeing, Morningstar
- Key Industries: Artificial intelligence, biotechnology, fintech, software, logistics technology
- Funding Landscape: $2.5 billion in venture capital funding in 2024 (Pitchbook)
- Notable Investors: Pritzker Group Venture Capital, Arch Venture Partners, MATH Venture Partners, Jump Capital, Hyde Park Venture Partners
- Research Centers and Universities: Northwestern University, University of Chicago, University of Illinois Urbana-Champaign, Illinois Institute of Technology, Argonne National Laboratory, Fermi National Accelerator Laboratory
