JOB SUMMARY:

The Pharmacy Benefit Administration Specialist will establish day to day support relationships with operational areas. Pharmacy Benefit Administration Specialist will be responsible for managing tasks and projects related to implementations, benefits, pricing, hierarchy, sets ups, testing and maintenance. The Benefits Administration Specialist will be actively engaged and involved in client interaction including client implementation discovery and working sessions. Benefit Administration Specialist will be subject matter for items noted above in addition to knowing and understanding how these interact or impact other areas such as pricing, clinical, etc. Benefits Administration Specialist will act as a junior implementation manager able to assist in multiple areas of an implementation.

PRIMARY JOB DUTIES & RESPONSIBILITIES:

Lead and monitor the full implementation process from initiation to deployment to ensure all deliverables are met according to contract

• Develop a knowledge about pharmacy claims and RxSense claims platforms.
• Set up and maintain benefits, clinical, networks, pricing and hierarchies
• Establish/maintain relationships with client services, pharmacy networks, implementations, UAT/QA, IT, finance, clinical staff with focus on flawless implementations
• Assist implementation team during client implementation calls on benefit and hierarchy discovery and configuration sessions.
• Gain a thorough understanding of client benefit designs and implement accurately
• Build solid working relationships both internally and externally with clients
• Test set ups prior to implement to production
• Troubleshoot benefit set up issues and propose solutions including updating processes to avoid future issues
• Coordinate impact analysis for identified issues
• Assist clients on best approach for their set up needs in our consultative role
• Assist management in developing and maintaining department policy and procedures
• Assist the Director and staff with process and development projects
• Other duties as assigned

DESIRED KNOWLEDGE, SKILLS, & ABILITIES:

• Working knowledge of RXSENSE products and processes.
• Must be able to develop and maintain strong working relationships on a multi-level basis.
• Superior written and verbal communication skills - ability to communicate information & ideas clearly & concisely both internal and external (client facing)
• Excellent organizational & time management skills.
• Ability to work in a dynamic fast paced atmosphere.
• Proven ability to work with minimal assistance and drive results
• Detail oriented, ability to multitask, proactive thinker
• Experience with pharmacy claims processing, benefit design, testing, hierarchy, copayment, accumulators, clinical rules
• Experience with client implementations
• Ability to research, analyze and resolve pharmacy benefit issues with minimal assistance.
• Ability to take the assist on projects

Education and/or Experience:

• Bachelor's degree or equivalent experience in healthcare (PBM), client implementations, plan builds, customer service, and claims processing.
• Experience with pharmacy technology and claims processing. Strong Experience with Microsoft Suite

Salary Range: 55,000 - 70,000