What are the responsibilities and job description for the Pharmacy Benefits Specialist position at Benecard Services Inc.?
This role will be responsible for the end-to-end creation and ongoing maintenance of client Implementation Guides, which are critical to accurately configuring pharmacy benefits for our clients.
This role requires expert-level knowledge of prescription benefits, strong systems understanding, and the ability to interpret complex plan design documentation from other carriers. Specialist will ensure plan designs meet client expectations while complying with regulatory requirements and system capabilities.
Must report on site 5 days a week
Duties and Responsibilities:
- Own the development and updates of Implementation Guides for all new and renewing clients
- Analyze and interpret external carrier plan designs to create accurate, system-ready documentation
- Collaborate closely with the Client Success, Clinical and Plan Setup teams to ensure alignment and accuracy
- Evaluate benefit interdependencies and ensure all plan design configurations are logically consistent and complete
- Articulate benefit design options, limitations, and best practices to internal stakeholders
- Stay current on ACA requirements, state regulations, and clinical program capabilities
- Support testing and validation processes during implementation cycles
- Maintain version control and auditability of Implementation Guides
Qualifications:
- Minimum 3-5 years experience in pharmacy benefits, PBM operations, or healthcare plan configuration
- Deep understanding of prescription benefit design, clinical programs, and plan configuration systems
- Proven ability to interpret plan design documents from external carriers
- Knowledge of ACA mandates and state-specific benefit rules
- Extremely detail-oriented and organized
- Strong time management and prioritization skills
- Excellent communication and collaboration skills
- Experience working cross-functionally with implementation or client-facing teams
Preferred Qualifications:
- Experience with benefit setup in a PBM system
- Familiarity with health plan or TPA operations
- Process improvement or documentation experience
Benecard Services, LLC
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.
Website: http://www.benecard.com
BeneCard PBF
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.
Website: http://benecardpbf.com
National Vision Administrators
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.
Website: http://www.e-nva.com
We are an Equal Opportunity employer.