Pharmacy Services Specialist

About This Opportunity

Our talent team is representing a confidential health insurance organization seeking a Pharmacy Services Specialist to join their team. In this role, you'll coordinate pharmacy benefit administration operations and serve as a subject matter expert for both established processes and new initiatives across their benefit programs.

Responsibilities

• Provide daily coordination of pharmacy benefit management operations and activities
• Support staff and coordinate research, development, implementation, and evaluation of pharmacy programs and initiatives
• Serve as a resource and subject matter expert on pharmacy needs, impacts, and projects for assigned initiatives
• Resolve operational issues and escalate to management when appropriate; assist with clinical and contractual matters
• Coordinate benefit plan administration review, implementation, and quality assurance with internal stakeholders and PBM partners
• Resolve or coordinate resolution of escalated customer service inquiries and grievances, including pharmacy claim adjustments
• Coordinate pharmacy coverage determinations with clinical staff and external partners
• Manage pharmacy claim reconsiderations and appeals coordination with relevant departments
• Respond to and coordinate review of RFPs, government program applications, and similar requests

What We're Looking For

• High School Diploma or GED required
• 3+ years of experience in pharmacy benefits, healthcare administration, or related fields
• Strong communication and interpersonal skills for cross-functional collaboration
• Excellent time management and organizational abilities
• Proficiency with Microsoft Office Suite
• Flexibility to work weekends and holidays as needed to support operational requirements

How We Work With You

When you apply through Get A Job.ai, one of our experienced recruiters will review your background and conduct an initial screening conversation. If there's a strong match, we'll submit your profile to our client for consideration. Please do not contact the employer directly—all communication flows through our recruitment team to ensure a professional and organized process.

Pay

Compensation details will be discussed during the screening process based on your experience and qualifications.

Equal Opportunity

Get A Job.ai is committed to inclusive hiring practices and welcomes applications from candidates of all backgrounds.