Pharmacy Operations Specialist

Hawaii Medical Service Association • Honolulu, HI

3d

About The Position

The Pharmacy Operations Specialist executes pharmacy operational processes and activities within an assigned line of business and supports implementation of pharmacy benefit, communication, and operational changes. The role performs operational tasks accurately and on time while adhering to departmental procedures, controls, and service standards.

The specialist supports pharmacy benefit administration through requirements interpretation, impact analysis, benefit testing, validation, and implementation readiness. The role reviews operational outputs for discrepancies or data concerns, helps maintain procedures and process materials, and monitors benefit accuracy through testing, validation, and live claim review.

The position also supports identifying and resolving operational issues, member- and pharmacy-related activities, communications quality review, and continuous improvement. It involves escalating issues as appropriate, assisting investigations and remediation, supporting cross-training, and contributing to a collaborative, service-oriented team.

Requirements

• Bachelor's degree and two years of related work experience, or an equivalent combination of education and related work experience.
• Strong organization and time management skills to manage multiple tasks and/or projects simultaneously and meet deadlines and implementation timeframes.
• Proficiency in issue identification, resolution, and program operations.
• Basic working knowledge of Microsoft Office applications, including Word, Excel, Outlook, and PowerPoint.

Responsibilities

• Execute pharmacy operational processes and activities within an assigned line of business.
• Support implementation of pharmacy benefit, communication, and operational changes.
• Perform operational tasks accurately and within established timelines while following departmental procedures, controls, and service standards.
• Interpret requirements and impact analyses and conduct benefit testing to validate accuracy and intended results.
• Analyze and assess business problems, including benefit or product changes, formulary changes, and system enhancements or redesigns.
• Support benefit configuration validation, testing activities, and implementation readiness efforts.
• Review operational outputs to identify discrepancies, issues, or data concerns.
• Assist with documentation and maintenance of operational procedures and process materials.
• Support pharmacy benefit administration and operational execution.
• Monitor and evaluate pharmacy drug benefit accuracy through testing reviews and validations; report monitoring results and/or live claim reviews.
• Identify and assess operational issues, discrepancies, or process breakdowns and determine the basis for concern.
• Address issues within established scope and determine when escalation or guidance is needed.
• Escalate issues requiring analyst, pharmacist, and/or leadership review.
• Gather information and documentation to support issue investigation and resolution.
• Participate in implementation and remediation activities as directed.
• Support operational activities affecting members, pharmacies, and internal stakeholders.
• Assist with execution and quality review of pharmacy-related communications.
• Monitor assigned activities for potential member impact and escalate concerns appropriately.
• Identify opportunities to streamline operational workflows and improve efficiency.
• Participate in process improvement efforts and operational readiness activities.
• Support cross-training initiatives and maintain knowledge of multiple operational processes.
• Contribute to a collaborative and service-oriented team environment.
• Perform other miscellaneous responsibilities and duties as assigned or directed.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level