PBM Coordinator, Benefit Configuration

Rightway•Miami, FL

1d•$23 - $27

About The Position

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.

Requirements

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

Nice To Haves

Pharmacy Technician or related experience highly desirable

Responsibilities

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.
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.
Configure and maintain benefit plans, copay structures, and formulary schedules; update benefit parameters and coverage rules as needed.
Generate and analyze benefit utilization reports and formulary compliance metrics to monitor plan performance and ensure accurate benefit administration.
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.
Support the PBM Pharmacy Associate with daily benefit configuration tasks and formulary maintenance. Also support daily tracking of benefit plan updates and formulary changes.
Partner with the PBM Pharmacy Associate to address and resolve complex benefit configuration and formulary-related issues.
Ensure that all documentation regarding benefit plan setups, formulary configurations, and implementations is current and accurate.