Pharmacy Benefits Specialist Health Plan Advocate - 4.5 Grand Rapids, MI Job Details Full-time From $19 an hour 1 day ago Benefits Continuing education credits Health savings account Health insurance Paid time off Flexible schedule Life insurance Retirement plan Qualifications Health insurance policy knowledge HIPAA Attention to detail Health information regulatory compliance Productivity software Critical thinking Medical terminology Health insurance management Full Job Description Job Summary Help employees access affordable medications and better health benefits! At Health Plan Advocate, we help employers and employees maximize the value of their health benefits. Through our Pharmacy Savings Program, we identify cost-saving opportunities that reduce prescription drug expenses while improving members' access to necessary medications. We're looking for a detail-oriented, analytical professional who enjoys solving problems, working with data, and leveraging technology to drive meaningful results. In this role, your work will directly impact thousands of health plan members by ensuring pharmacy benefits are administered accurately and savings opportunities are captured. If you're someone who enjoys investigating issues, learning new systems, and making a measurable difference behind the scenes, we'd love to meet you. As a Pharmacy Benefit Specialist, you'll play a critical role in delivering savings and ensuring the accuracy of pharmacy benefit administration. Primary Responsibilities

• Maintain and manage pharmacy benefit data within partner PBM systems, ensuring accuracy and completeness
• Review health plan designs, claims information, and member data to identify savings opportunities and discrepancies
• Investigate and resolve pharmacy claims issues and benefit processing errors
• Analyze data to uncover missed opportunities that improve member outcomes and reduce costs
• Collaborate with internal teams to implement updates that impact pharmacy savings programs
• Ensure all work is completed in compliance with HIPAA privacy and security requirements Required Qualifications
• Experience working with employer-sponsored health insurance plans, including traditional and High Deductible Health Plans (HDHPs)
• Understanding of pharmacy benefits, formularies, copays, deductibles, and member cost-sharing structures
• Strong computer proficiency, including Microsoft Office, databases, and web-based applications
• Excellent analytical, critical thinking, and problem-solving skills
• Outstanding attention to detail and commitment to accuracy
• Strong written and verbal communication abilities
• Ability to work independently while maintaining high productivity and quality standards
• Must be a non-tobacco user Preferred Qualifications
• Experience working with Pharmacy Benefit Managers (PBMs) or pharmacy benefit administration
• Knowledge of pharmacy claims processing, billing procedures, and medication terminology
• Experience using PBM platforms, benefits administration systems, or claims management software
• Background in employee benefits, insurance operations, or pharmacy services Benefits
• Health Insurance and Health Savings Account (HSA)
• Life Insurance
• SIMPLE Retirement Plan
• Paid Time Off

Job Related Continuing Education Reimbursement Pay:

From $19.00 per hour Expected hours: 40.0 per week

Benefits:

Flexible schedule Health insurance Health savings account Paid time off Retirement plan

Work Location:

Hybrid remote in Grand Rapids, MI 49546