Benefits Workflow Manager

Job Summary

Seeking a detail-oriented Manager, Benefits Workflow & Plan Governance, this full-time position will manage compliance with ERISA and member equity standards while architecting workflows for complex scenarios and ensuring a seamless experience for members in a remote work environment.

Key responsibilities

• Define and maintain the "Rules of Engagement" for plan transitions and intake decisions to eliminate ambiguity for internal teams
• Ensure compliance with employer plan primacy and develop protocols for handling non-primary payer inquiries
• Collaborate cross-functionally to create decision trees and scripts for patient intake, ensuring alignment with legal and operational requirements

Required qualifications

• 5+ years of experience in Healthcare Operations, Benefits Administration, or Governance/Compliance roles
• Strong understanding of ERISA regulations, particularly regarding member equity and plan documentation
• Proven ability to translate complex policies into executable workflows for front-line teams
• Experience in operational design and process improvement
• Ability to communicate effectively between legal requirements and operational needs