Located in La Jolla, this is a remote local position.
Join the Scripps Health team and work alongside passionate caregivers providing patient-centered healthcare. Receive endless appreciation while you build a rewarding career with one of the most respected healthcare organizations nationwide.
Why join Scripps Health?
AWARD-WINNING WORKPLACE:
- #5 in Fortune Best Workplaces in Health Care 2023
- #78 in 2023 PEOPLE Companies that Care
- #95 in Fortune 100 Best Companies to Work for 2023
- Recognized by Newsweek as one of America's Greatest Workplaces for Diversity in 2024
- Nearly a quarter of our employees have been with Scripps Health for over 10 years.
Ø Be responsible for administering and reporting for the pharmacy plan, self-funded health plans, including interaction and oversight of the designated TPA and Pharmacy Benefit Manager (PBM); and all medical, behavioral health, and pharmacy programs leadership including committees to review plan design, make recommendations, costing and appeal decisions.
Ø Coordinate with TPA, PBM and consultants for monthly reporting of health plan financials to Health Plan Advisory Board. Responsible for financial performance of the plans.
Ø Analyze monthly reporting to identify trends, variances, and plan outliers; makes recommendations for efficiencies and/or corrections.
Ø P ar tner with internal Pharmacy, support in the expansion of 340b program to targeted populations.
Ø Responsible for adherence to regulatory requirements including, but not limited to, ACA reporting, RXDC reporting, 5500 filing, Non-Discrimination Testing
Ø Administers executive benefit programs with TPAs to include new enrollment, tax reporting, compliance, budget, billing and problem resolution.
Ø Oversees Executive Benefits in cooperation with the Sr Corporate Vice President.
Qualifications
Required Education/Experience/Specialized Skills:
• Bachelor's degree plus 7 years experience in Benefits Administration, 5 of which with self-funded health plans.
• Experience leading and coordinating complex and politically sensitive projects.
• Experience with administering 401K or 403B retirement plans.
Preferred Education/Experience/Specialized Skills/Certification:
• Master's degree.