Pharmacy Benefits Specialist

Benecard Services Inc. • Mechanicsburg, PA

29d • Onsite

About The Position

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

Requirements

• 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

Nice To Haves

• Experience with benefit setup in a PBM system
• Familiarity with health plan or TPA operations
• Process improvement or documentation experience

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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed