Sr. Benefits Administration Analyst

Remote (United States)

About the Role

We are seeking an experienced Sr. Benefits Administration Analyst to serve as a senior-level subject matter expert within a solutions delivery organization. In this role, you will lead complex client implementations, oversee benefit configuration initiatives, drive process improvements, and provide technical guidance to team members.

This position requires deep expertise in pharmacy benefit management, benefit design, claims processing platforms, and client-facing implementation projects. You will work closely with clients and cross-functional teams to ensure accurate benefit setup, successful implementations, operational excellence, and long-term client satisfaction.

Status: Full Time

Salary: $75,000 - $113,000 per year

What You’ll Do

Implementation Leadership

• Lead the full implementation lifecycle for large, complex, and strategic clients from project initiation through production deployment.
• Ensure all contractual deliverables are completed accurately, on time, and within scope.
• Serve as the primary benefits configuration expert during client discovery, requirements gathering, and configuration sessions.
• Identify implementation risks proactively, develop contingency plans, and communicate recommended solutions to leadership.
• Review and validate benefit setups completed 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 benefit hierarchies across claims processing platforms.
• Develop advanced expertise in platform capabilities and limitations while serving as an internal resource for benefit administration guidance.
• Lead root-cause analysis for complex benefit setup issues and implement process improvements to prevent recurrence.
• Conduct impact assessments for platform changes, client requests, and identified issues affecting benefit configurations.

Client & Stakeholder Engagement

• Build and maintain trusted advisor relationships with clients while serving as a consultative partner on benefit design strategy and platform optimization.
• Represent Benefits Administration in cross-functional meetings, client steering committees, and escalation discussions.
• Collaborate with Client Services, Pharmacy Networks, UAT/QA, IT, Finance, and Clinical teams to support successful 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 clients covering benefit setup requirements and platform best practices.
• Serve as an escalation resource for complex or ambiguous benefit configuration challenges.

Process & Operational Excellence

• Lead initiatives to improve departmental workflows, documentation standards, and quality processes.
• Assist in developing and maintaining department policies, procedures, and operational best practices.
• Contribute to strategic projects and product initiatives as a subject matter expert.

Qualifications

• Bachelor’s degree or equivalent experience in healthcare, pharmacy benefit management, or a related field.
• 5+ years of experience in pharmacy benefit management, client implementations, benefit administration, or plan build operations.
• At least 2 years of experience in a senior-level or lead capacity.
• Experience working with PBM claims processing platforms is required.
• Experience with pharmacy benefit administration platforms is strongly preferred.
• Previous experience in a consultative, client-facing role is strongly preferred.
• Strong expertise in pharmacy benefit management, benefit design, and claims platform functionality.
• Ability to manage complex implementations and multiple benefit configuration workstreams simultaneously.
• Strong analytical, problem-solving, and decision-making skills.
• Excellent written and verbal communication skills.
• Ability to collaborate effectively with clients, leadership teams, and cross-functional stakeholders.
• Experience mentoring team members and providing technical guidance is preferred.