Payroll and Total Rewards Manager

Pharmacy1st Health is building the clinical infrastructure for rural America by transforming independent pharmacies into integrated care delivery hubs. Our model combines primary care, pharmacy services, and chronic disease management under one roof, creating a new, lower-cost site of care for underserved communities.

We operate across multiple states and are rapidly expanding a network of rural clinics co-located with pharmacies. Our goal is to deliver scalable, high-quality care while improving access, outcomes, and cost efficiency.

Position Overview

The Total Rewards Manager will play a critical role in designing and administering the programs that ensure our employees are cared for, paid accurately, and rewarded competitively. This role sits at the intersection of benefits, payroll, and compensation strategy and will help ensure our growing workforce has access to high quality benefits, seamless payroll operations, and meaningful rewards.

This role requires someone who is both detail oriented and strategic. You must be comfortable managing day to day operations while also improving programs, negotiating with vendors, and supporting a rapidly growing organization.

Key Responsibilities

• Manage the relationship with benefits brokers and insurance carriers across medical, dental, vision, and ancillary plans

• Support plan design and renewal negotiations to ensure competitive and cost effective benefits for employees

• Lead annual open enrollment including employee communications, education sessions, and enrollment administration

• Ensure benefit offerings remain compliant with federal and state regulations while scaling across multiple states

• Partner with HR leadership to evaluate and introduce new benefits that support clinicians working in rural communities

• Oversee payroll processing and accuracy through Gusto for a multi state workforce

• Ensure employee pay, deductions, benefits contributions, and tax filings are accurate and compliant

• Partner with finance to support payroll reporting, audits, and reconciliation

• Continuously improve payroll processes to support a growing employee population

• Maintain salary bands and compensation structures aligned with market benchmarks and internal equity

• Support compensation analysis for new hires, promotions, and acquisitions

• Assist with profit sharing programs, incentives, and other reward structures tied to company performance

• Help design creative perks and benefits that strengthen employee retention and engagement

• Identify opportunities to improve employee rewards programs as the company scales

• Build documentation and processes to ensure benefits and payroll operations remain efficient and compliant

• Partner cross functionally with HR, finance, and leadership to ensure our total rewards strategy supports company growth

Qualifications

• 4 to 7 years of experience in benefits administration, or compensation and payroll

• Strong experience working with benefits brokers and managing open enrollment

• Experience administering payroll systems such as Gusto, ADP, or similar platforms

• Strong analytical mindset with the ability to evaluate compensation and benefits programs

• Comfortable operating in a high growth environment where processes are being built and improved

• Excellent communication skills with the ability to explain benefits and compensation programs clearly to employees