Pharmacy Design Consultant

This role is responsible for the end-to-end development and ongoing maintenance of client Implementation Guides, which are essential for accurately configuring pharmacy benefits. The position requires expert-level knowledge of prescription benefits, strong systems proficiency, and the ability to interpret complex plan design documentation from other carriers. Pharmacy Design Consultant will partner closely with internal teams and external stakeholders to ensure that all plan designs align with client expectations while adhering to regulatory requirements and system capabilities.Key ResponsibilitiesBenefit Plan Design & DocumentationLead the end-to-end creation, validation, loading and maintenance of pharmacy benefit plan designs/IG'sDevelop and maintain client Implementation Guides, ensuring accuracy, clarity, and alignment with benefit requirementsTranslate complex client benefit requests into actionable system configurations within established capabilitiesProvide guidance to cross-functional teams, including Client Success, Operations, Compliance, and OperationsRecommend best practices for benefit design to ensure accuracy, efficiency, and consistency across clientsQuality Assurance, Testing & MonitoringProvide support and 2nd set of eyes on all new client implementations testingCross-Functional Collaboration & SupportWork closely with implementation teams to ensure smooth client onboarding and benefit transitionsSupport internal teams with benefit interpretation questions and technical clarificationsStay current on ACA requirements, state regulations, and clinical program capabilitiesMaintain version control and auditability of Implementation GuidesQualifications:RequiredMinimum of 3-5 years' experience in pharmacy benefits, PBM operations or healthcare plan configurationProven ability to interpret plan design documents from external carriersKnowledge of ACA mandates and state-specific benefit rulesStrong time management and prioritization skillsExcellent communication and collaboration skillsExperience working cross-functionally with implementation or client-facing teamsExtremely detail-oriented and organizedPreferred Experience with benefit setup in a PBM systemFamiliarity with health plan or TPA operationsProcess improvement or documentation experiencePrescription claims adjudication experienceBenecard Services, LLCBenecard Services, LLC has been administering carve-out, fixed rate insured prescription drug benefit programs since 1990. Benecard is a full service, in-house prescription benefit administrator that includes mail and specialty drug dispensing. We are a premiere nationwide Prescription Benefit Administrator headquartered in Lawrenceville, New Jersey.Website: PBFBeneCard PBF provides self-funded prescription benefit program administration with a personalized approach through focused, clinical expertise. Our business model operates on a customized claim processing system offering unlimited capability and flexibility to respond to client needs in an evolving marketplace. Advanced clinical programs and advanced technology provide the framework to maximize the use of all data elements available. This allows BeneCard PBF to filter the information, focus on clinical opportunities and facilitate interaction between the physician, the pharmacist and the patient to effectively promote complete health care. Headquartered in Bonita Springs, Florida.Website: Vision AdministratorsFor over 40 years, National Vision Administrators (NVA) has been meeting the vision benefit needs of public employer groups, Health & Welfare Funds, Associations and Coalitions. Providing millions of people throughout the United States with vision care programs that help them be smarter buyers of eye care and eyewear, NVA is particularly well suited to address today's health benefit challenges as it relates to eye care. We offer cost-effective, customized vision benefit programs that are clinically integrated. We are proud of the fact that we have retained over 99% of our clients and believe it is the greatest testimony to the high-quality benefits and service satisfaction we provide to both our clients and their members. Headquartered in Clifton, New Jersey.Website: are an Equal Opportunity employer.

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