Pharmacy Specialist

Corewell Health • Grand Rapids, MI

5d • Hybrid

About The Position

This position follows a hybrid schedule with one onsite day per week on Thursdays. Additional onsite days may be required periodically to support meetings, project work, or evolving team and business needs. Are you passionate about ensuring pharmacy benefits are accurate, compliant, and working seamlessly behind the scenes? As a Pharmacy Specialist – primary focus on Part B and Part D determinations, Hospice, and ESRD - you’ll play a critical role in supporting pharmacy operations by partnering closely with the Pharmacy Benefit Managers (PBM), vendors, and internal teams to ensure benefit designs and systems are configured and administered correctly. This role is ideal for someone who thrives at the intersection of pharmacy operations, data integrity, and regulatory compliance—and who enjoys solving complex issues to support members, employer groups, and internal stakeholders alike.

Requirements

• 2 years of related experience

Nice To Haves

• Bachelor's Degree or equivalent

Responsibilities

• Assists in developing and maintaining of the pharmacy operations systems.
• Direct interaction with Pharmacy Benefit Manager and other pharmacy vendors to ensure all systems and pharmacy benefits are administered accurately.
• Assist external and internal customers with pharmacy benefit and administration questions and issue resolution.
• Ensures governmental compliance by monitoring and auditing various vendors and processes.
• Monitors extract exchanges with vendors and escalates concerns.
• Work with internal teams to create benefit grids and custom plan requests for system set up, and tests to ensure accurate configuration with the PBM.
• Implements, audits and validates drug formulary changes and processes submissions to regulatory bodies.
• Coordinates member communication with Marketing.
• Reporting and analyzing data to ensure accuracy and compliance.
• Participates and reports on behalf of the company in a variety of audits from governing bodies.
• Oversees PBM, vendors, and internal processes to ensure compliance.
• Communicates effectively with internal and external customers, avoiding jargon to ensure understanding.
• Participates in projects to represent Pharmacy Operations.

Benefits

• Comprehensive benefits package to meet your financial, health, and work/life balance goals.
• On-demand pay program powered by Payactiv
• Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
• Optional identity theft protection, home and auto insurance
• Traditional and Roth retirement options with service contribution and match savings

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree