Benefits Operations-
Your health plan, managed every month.
Who is Managing Your Benefits
Most employers assume their vendors and broker are managing the health plan. They aren't, and it isn't their job. Your vendors administer the plan: they run the networks, process claims and answer member questions. Your broker helps you shop for coverage and renew it. But no one is managing the plan itself: checking the bills, holding vendors to their contracts, and reviewing the care behind your biggest claims. Benefits Operations fills that gap. It's the same ongoing management your finance team already gives every other major expense.
What RxClarity will do every month
-
Reconcile. We compare what you were billed with what you actually owed.
-
Verify. We check every vendor against its contract: PBM, TPA, medical and stop-loss.
-
Review. A clinician looks at the care behind your highest-cost claims.
-
Act. We fix what's wrong, working with your vendors directly.
-
Report. You see the results and get help with your next decisions.
Who does the work
A clinician reviews the care. A data architect proves the numbers. You get one team working on your plan, with no financial interest in what gets billed.
What's included
-
Controllership & Oversight: monthly checks on contracts, billing and performance, compliance
-
Clinical Case Management: clinician-led support for complex, high-cost members
-
Procurement & RFP: only when the data shows a change is needed
How to start
Every engagement starts with a Plan Baseline. It has a fixed scope and takes 21 days. We review your data, your goals, and what's working and what isn't. The report is yours whether you engage us or not.
Schedule time to set up you Plan Baseline. Starting with Pharmacy