Senior Pharmacy Benefits Specialist
2 weeks ago
As a Senior Pharmacy Benefits Specialist, you will take a leadership role in driving the quality and consistency of Implementation Guide development within the Plan Setup Team. In addition to fulfilling all specialist duties, this senior position will mentor junior specialists, help establish standards and best practices for Implementation Guide documentation, and act as a liaison between Client Success and technical teams for escalated or complex plan configurations.
Duties
and Responsibilities Lead the development of Implementation Guides for high-complexity clients Review and approve work of junior analysts for accuracy and completeness Define documentation standards, templates, and governance processes Serve as escalation point for questions regarding benefit dependencies and configuration limitations Partner with clinical, legal, and compliance teams to ensure designs meet regulatory and programmatic requirements Act as a knowledge resource across the team for ACA compliance, clinical integration, and system capabilities Participate in client calls when needed to explain design decisions or limitations Qualifications 5+ years in pharmacy benefits with experience in plan configuration or benefit strategy Deep understanding of system configuration capabilities and dependencies Strong analytical and problem-solving skills Ability to lead documentation initiatives and mentor peers Exceptional attention to detail Collaborative mindset with excellent communication skills Preferred Qualifications Change control or configuration governance experience Process improvement or operational excellence certification (e.g., Lean Six Sigma) Benecard Services, LLC has been administering carve-out, fixed rate insured prescription drug benefit programs since 1990. Benecard is a full service, in-house prescription benefit administrator that includes mail and specialty drug dispensing. We are a premiere nationwide Prescription Benefit Administrator headquartered in Lawrenceville, New Jersey. BeneCard PBF provides self-funded prescription benefit program administration with a personalized approach through focused, clinical expertise.
Our business model operates on a customized claim processing system offering unlimited capability and flexibility to respond to client needs in an evolving marketplace. Advanced clinical programs and advanced technology provide the framework to maximize the use of all data elements available. This allows BeneCard PBF to filter the information, focus on clinical opportunities and facilitate interaction between the physician, the pharmacist and the patient to effectively promote complete health care. Headquartered in Bonita Springs, Florida.
For over 40 years, National Vision Administrators (NVA) has been meeting the vision benefit needs of public employer groups, Health & Welfare Funds, Associations and Coalitions. Providing millions of people throughout the United States with vision care programs that help them be smarter buyers of eye care and eyewear, NVA is particularly well suited to address today's health benefit challenges as it relates to eye care. We offer cost-effective, customized vision benefit programs that are clinically integrated. We are proud of the fact that we have retained over 99% of our clients and believe it is the greatest testimony to the high-quality benefits and service satisfaction we provide to both our clients and their members.
Headquartered in Clifton, New Jersey. #J-18808-Ljbffr
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Town of Florida, United States Benecardpbf Full timeA leading pharmacy benefits administrator is seeking a Senior Pharmacy Benefits Specialist to drive the quality of Implementation Guide development. Responsibilities include mentoring junior specialists and establishing standards for documentation. The ideal candidate has 5+ years of experience in pharmacy benefits and strong analytical skills. This role...
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Senior Pharmacy Benefits Specialist
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Pharmacy Benefits Specialist
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