PBM Coordinator, Benefit Configuration

ABOUT THE ROLE:

The PBM Benefits Coordinator is a member of the Rightway Operations team reporting to the Manager of Benefit Configuration. This role will be responsible for the day-to-day inquiries and operations related to benefit configuration and administration, specifically focusing on benefit plan setup.

WHAT YOU’LL DO:

Primary Contact: Serve as the main point of contact for all internal inquiries related to benefit configuration, formulary management, and plan setup, ensuring timely and accurate resolution.

Troubleshooting: Research and troubleshoot inquiries or issues related to benefit configurations and formulary setups. This includes reviewing benefit plan documents and formulary files to identify and resolve discrepancies.

Benefit Management: Configure and maintain benefit plans, copay structures, and formulary schedules; update benefit parameters and coverage rules as needed.

Reporting: Generate and analyze benefit utilization reports and formulary compliance metrics to monitor plan performance and ensure accurate benefit administration.

Collaboration: Work closely with various departments, including Account Management, the Contact Center, and the Clinical Team, to resolve benefit-specific issues and address or escalate broader client concerns.

Assistance: Support the PBM Pharmacy Associate with daily benefit configuration tasks and formulary maintenance. Also support daily tracking of benefit plan updates and formulary changes.

Complex Issue Resolution: Partner with the PBM Pharmacy Associate to address and resolve complex benefit configuration and formulary-related issues.

Documentation: Ensure that all documentation regarding benefit plan setups, formulary configurations, and implementations is current and accurate.

WHO YOU ARE:

Pharmacy Technician or related experience highly desirable

1-3 years of PBM experience in benefits administration or plan configuration

COMPENSATION: $23.00 - $27.00/hr

Compensation offered will be determined by geographic location, experience, and qualifications.