Manager, Technical Integration

What We're About... TrueScripts Management Services is a pharmacist-founded, fully transparent Prescription Benefit Manager that has been revolutionizing the PBM industry since 2014. Our mission is to build lasting relationships by providing prescription benefit expertise at a personal and customized level to ensure optimum value at the lowest possible cost. We are committed to lowering prescription drug spending, achieving clinically effective outcomes, and always delivering Amazing Care. Did we mention Amazing Care ? Good! Because this is so much more than just our tagline. It is the foundation upon which our business was built. We believe that Amazing Care starts from within, and our culture is reflective of this philosophy.
Our team members enjoy:

• A wide range of health insurance options including medical, dental and vision
• A strong salary and bonus program
• A robust 401k and company match
• Truescripts is transitioning to an ESOP, a team member owned company! Each year team members are allocated shares of stock through our ESOP, a Qualified Retirement plan!
• A wellness program including financial incentives, chiropractic and massage services, and fitness stipends
• Dream Manager Program (yes, it's a real thing!)
• A cohesive, family-based culture
• Charitable contributions and volunteer time
• Lots of celebrations!

Ok, enough about us. Here's what we need from you: A future team members' values need to align with TrueScripts' core values of Integrity, Respect, Innovation, and Service. This match in value systems is critical for our team's chemistry and continued success. Our culture is positive, and our people possess a 'can do, proactive attitude. Honesty and transparency are the foundation that we build upon. What sets us apart from our competitors is the programs that we bring, the education that we provide, and the utmost respect for clients and their members to assist them when and where needed.
Position Overview:
The Manager of Technical Integration is a strategic leader responsible for overseeing all aspects of accumulator and eligibility systems within the TrueScripts prescription benefit management organization. This individual may lead technical and cross-functional teams in designing, implementing, and optimizing processes that ensure accurate accumulator tracking and seamless eligibility integration with internal and external partners. The role demands a blend of technical acumen, PBM industry expertise, and operational leadership.
Primary Roles and Responsibilities:
Accumulator Management

• Oversee the accurate setup, maintenance, and performance of accumulator systems to track member benefit utilization.
• Ensure compliance with accumulator policies for both pharmacy and medical benefit coordination.
• Collaborate with plan sponsors, clients, and adjudication vendors to manage accumulators of benefit design changes, manufacturer assistance programs, and other cost-offset programs.
• Lead the resolution of accumulator-related discrepancies and audit findings.

Eligibility Oversight

• Manage the end-to-end eligibility process, including data ingestion, validation, integration, and troubleshooting with third-party administrators (TPAs), employer groups, and carriers.
• Ensure timely and accurate eligibility file processing, minimizing disruption to member access and claims adjudication.
• Partner with IT and Client Success to develop and maintain best practices around eligibility file formats, error resolution, and version control.

Leadership & Strategy

• Lead, mentor, and develop a team of analysts and technical specialists focused on accumulators and eligibility.
• Establish KPIs and operational dashboards to monitor performance, detect issues, and support strategic decision-making.
• Drive system enhancements and automation initiatives in collaboration with IT, product, and vendor partners.

Vendor & Partner Coordination

• Serve as the primary liaison for technical operations with PBM adjudication vendors and third-party data exchange partners.
• Ensure SLAs are met for eligibility file processing and accumulator updates.
• Participate in vendor evaluations and contract negotiations relevant to technical services.

Requirements
Education:

• Bachelor's degree in computer science, Health Informatics, Business, or related field; or equivalent work experience

Experience/Knowledge:

• Minimum 7-10 years of experience in the PBM, healthcare, or insurance industry, with a strong focus on eligibility systems and accumulators.
• Deep understanding of PBM operations, benefit plan structures, and claims adjudication systems.
• Proven experience leading technical operations or systems integration teams.
• Strong project management skills, with experience in Agile or Lean methodologies.
• Exceptional analytical, problem-solving, and interpersonal skills.
• Experience with eligibility standards (HIPAA 834, etc.) and accumulator impacts (e.g., copay adjustment programs) highly desirable.