Exemption Status:

“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Summary

The Manager, Benefit Design Administration & Testing is responsible for leading the successful administration, validation, and ongoing maintenance of benefit plan designs and associated pricing components across multiple lines of business. This role oversees a team of testing professionals, ensuring the accurate implementation of client requirements, regulatory compliance, and operational excellence.

The Manager drives quality assurance initiatives, manages workflow and staffing strategies, supports client implementations and benefit changes, and fosters continuous process improvement to enhance scalability, efficiency, and service delivery. This position serves as a key liaison among Operations, Product, Technology, Account Management, and Client teams to ensure benefit configurations are implemented accurately and meet business and client expectations

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Accountable for maintaining a comprehensive understanding of Medicare benefit design, administration, and regulatory requirements to ensure plan configurations meet client and compliance expectations.
• Accountable for applying knowledge of Commercial Health Plan structures, operations, and benefit administration processes to support accurate and effective plan implementation.
• Accountable for delivering high-quality benefit administration services through a minimum of five (5) years of PBM, healthcare operations, or related industry expertise.
• Responsible for leading and developing team members while effectively managing workloads, competing priorities, project timelines, and service-level commitments.
• Accountable for analyzing complex data, identifying trends, and making informed recommendations that support operational and business objectives.
• Accountable for communicating effectively with clients, leadership, and cross-functional stakeholders through clear presentations, reporting, and written communications.
• Responsible for fostering a culture of ownership, collaboration, continuous improvement, and operational excellence within the Benefit Design Administration and Testing team.
• Accountable for ensuring accuracy, quality, compliance, and timely delivery of benefit configuration and testing activities while supporting organizational goals and client satisfaction.

Education and/or Experience –

BS/BA degree or equivalent plus 5+ years of experience; 1 year of SME in respective area(s); and 3+ years of supervisory experience; 4 years of MedImpact experience plus an appropriate external leadership training program and internal mentorship with a seasoned leader (Dir+) that must completed within 12 months in new position may substitute for the supervisory experience requirement.

Computer Skills

• Advanced proficiency in Microsoft Office Suite, including Excel (pivot tables, formulas, data analysis), Word, PowerPoint, Outlook, and Teams.
• Experience with test management and defect tracking tools such as Smartsheet, Jira, Azure DevOps, or similar platforms.
• Working knowledge of benefit administration, claims adjudication, PBM, and healthcare operations systems.
• Ability to analyze and interpret large data sets using reporting and business intelligence tools such as Power BI, Tableau, or equivalent reporting solutions.
• Experience developing, executing, and monitoring test plans, test cases, quality controls, and validation processes.
• Knowledge of SQL queries and database validation techniques for testing and troubleshooting preferred.
• Familiarity with software development lifecycle (SDLC), Agile methodologies, user acceptance testing (UAT), and quality assurance best practices.
• Experience utilizing workflow management, project management, and collaboration tools to manage team deliverables and testing activities.
• Ability to create dashboards, performance metrics, and executive-level reporting to support operational decision-making.
• Strong technical aptitude with the ability to learn and support new systems, technologies, and automation tools

Certificates, Licenses, Registrations

n/a

Other Skills and Abilities

• Experience in planning and execution of test plans and benefits design administration.
• Proven experience in team development, coaching, and performance management
• History of effectively establishing and implementing workforce plans and staffing forecasts
• Ability to make decisions and solve problems under pressure

Reasoning Ability –

• Ability to apply common sense understanding to carry out simple one- or two-step instructions.  Ability to deal with standardized situations with only occasional or no variables.

• Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.  Ability to deal with problems involving several concrete variables in standardized situations.

Mathematical Skills –

• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

• Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.

Language Skills –

• Ability to write routine reports and correspondence.  Ability to speak effectively before groups of customers or employees of organization.

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• Ability to write reports, business correspondence, and procedure manuals. 

Competencies To perform the job successfully, an individual should demonstrate the following competencies:

• Building Effective Teams
• Decision Quality
• Informing
• Confronting Direct Reports
• Delegation
• Organizational Agility
• Customer Focus
• Drive for Results
• Political Savvy

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Ability to maintain clear near visual acuity at approximately 20 inches or less (i.e., “close vision”) to accurately read fine print, view computer screens, and handle small objects. Requires adequate color vision and depth perception to support safety and precision in detail-oriented tasks.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes, or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers, light traffic).

Work Location

This position works on-site at the San Diego Headquarters or other company location (or from a remote location with management approval based on business requirements). Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders.

Working Hours

This is an exempt level position requiring the incumbent to work the hours required to fully accomplish job responsibilities and meet deadlines for work deliverables. The individual must have the flexibility to work beyond traditional hours and be able to work nights, weekends or on holidays as required. Work hours may be changed from time to time to meet the needs of the business. Typical core business hours are Monday through Friday from 8:00am to 5:00pm.

Travel

This position requires domestic travel of up to 10% of the time.

The Perks:

• Medical / Dental / Vision / Wellness Programs

• Paid Time Off / Company Paid Holidays

• Incentive Compensation

• 401K with Company match

• Life and Disability Insurance

• Tuition Reimbursement

• Employee Referral Bonus

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers

MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer, Male/Female/Disabilities/Veterans

OSHA/ADA:

To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer:

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.