PBA Account Operations Specialist

GalenusCare; New Jersey; Remote; USD 65,000 - 90,000; Full time

Job summary

ChorusRx is seeking a PBA Account Operations Specialist to coordinate daily account activities for assigned PBA accounts. This remote role supports implementations, service reporting, and issue resolution with a focus on documentation and stakeholder communication. Requires PBM operations experience and advanced MS Office skills; travel to Mt.

Laurel, NJ is possible. The role reports to the Director, PBA Services, and is full-time with 40+ hours per week.

Qualifications

• High school diploma or equivalent.
• Three or more years of PBM, health plan, member services, benefit administration, pharmacy operations, or related healthcare experience.
• Experience supporting Medicare Part D, PACE, PBM account operations, implementations, PDE-related activities.
• Experience coordinating multiple priorities, resolving operational issues, maintaining detailed documentation, and communicating with internal or external stakeholders.
• Working knowledge of pharmacy benefits, claims, eligibility, benefit configuration, or PBM operations.
• Advanced MS Office, Word, Excel, PowerPoint, and Outlook.
• Producing analytical reporting and interpreting pharmacy data.

Responsibilities

• Serve as the primary day-to-day operational contact for assigned accounts and coordinate routine requests, questions, and follow-up.
• Maintain account-specific requirements, contacts, calendars, deliverables, workflows, benefit documentation, open items, and decision logs.
• Track commitments, due dates, ownership, and resolution status; proactively follow up with internal teams and vendors.
• Prepare agendas, status updates, issue summaries, and action-item tracking for recurring account operational meetings.
• Build working knowledge of each account’s benefit design, operational requirements, service model, and escalation pathways.
• Triage incoming account issues, gather required facts, assign to owners, and monitor through resolution.
• Communicate status updates, next steps, and closure information to stakeholders.
• Maintain issue and escalation logs and identify recurring themes for leadership review.
• Escalate high-risk or unresolved issues according to procedures.
• Coordinate routine benefit, eligibility, file, and account-maintenance requests with PBM and support teams.
• Support account implementations, benefit changes, testing, readiness checklists, and post-go-live stabilization.
• Verify operational changes are documented, tested, communicated, and closed.
• Support reconciliation and data exchange deliverables.
• Coordinate recurring operational reports and validate receipt and discrepancies.
• Maintain account documentation, meeting materials, and evidence of completed deliverables.
• Prepare account-level service summaries and upcoming deliverables.
• Support audits, PDE activities, regulatory requests, or delegation monitoring.
• Collaborate with cross-functional teams and use established workflows with clear ownership.

Skills

PBM operations knowledge

Stakeholder communication

Analytical reporting

Project coordination

Education

CPhT certification

Tools

MS Office (Advanced: Word/Excel/PowerPoint/Outlook)

Python

AWS

Git

Job description

The PBA Account Operations Specialist serves as the day-to-day operational point of coordination for assigned PBA accounts. Designed for an experienced pharmacy technician or PBM operations professional, this role manages routine account activity, tracks requests and deliverables, coordinates issue resolution, maintains account documentation, and supports implementations and service reporting. The position does not own enterprise regulatory compliance, formal delegation oversight, or managerial responsibilities; significant compliance, vendor, or contractual risks are escalated to PBA leadership.

Reports to: Director, PBA Services
Location: Remote
Status: Full-time, 40+ hours per week

Key Responsibilities

Daily Account Management

• Serve as the primary day-to-day operational contact for assigned accounts and coordinate routine requests, questions, and follow-up.
• Maintain account-specific requirements, contacts, calendars, deliverables, workflows, benefit documentation, open items, and decision logs.
• Track commitments, due dates, ownership, and resolution status; proactively follow up with internal teams and vendors.
• Prepare agendas, status updates, issue summaries, and action-item tracking for recurring account operational meetings.
• Build working knowledge of each assigned account’s benefit design, operational requirements, service model, and escalation pathways.

Issue and Service Coordination

• Triage incoming account issues, gather required facts and documentation, assign or route work to the appropriate operational owner, and monitor through resolution.
• Communicate clear status updates, expected next steps, and closure information to stakeholders.
• Maintain issue and escalation logs and identify recurring themes for review by PBA leadership.
• Escalate high-risk, regulatory, contractual, member-impacting, or unresolved issues according to established procedures.

Benefit, Eligibility, and Implementation Support

• Coordinate routine benefit, eligibility, file, and account-maintenance requests with PBM, technology, pharmacy operations, and other support teams.
• Support account implementations, benefit changes, testing, readiness checklists, and post-go-live stabilization activities.
• Verify that requested operational changes are documented, tested where required, communicated, and closed.
• Support reconciliation and follow-up for account-specific data exchanges, reports, and operational deliverables.

Reporting and Documentation

• Coordinate recurring operational reports and validate receipt, completeness, and apparent discrepancies before distribution or escalation.
• Maintain organized account documentation, meeting materials, correspondence, procedure references, and evidence of completed deliverables.
• Prepare account-level service summaries showing open issues, trends, SLA performance, implementation milestones, and upcoming deliverables.
• Support data gathering for audits, PDE activities, regulatory requests, or delegation monitoring under the direction of PBA leadership.
• Partner with PBA operations, pharmacy operations, compliance, reporting and analytics, finance, technology, clinical teams, implementation teams, and PBM/vendor contacts.
• Use established workflows and escalation channels consistently, documenting ownership and handoffs.
• Recommend workflow improvements based on recurring account questions, service issues, and operational friction.

Qualifications

Required

• High school diploma or equivalent
• Three or more years of PBM, health plan, member services, benefit administration, pharmacy operations, or related healthcare experience.
• Experience supporting Medicare Part D, PACE, PBM account operations, implementations, PDE-related activities.
• Experience coordinating multiple priorities, resolving operational issues, maintaining detailed documentation, and communicating with internal or external stakeholders.
• Working knowledge of pharmacy benefits, claims, eligibility, benefit configuration, or PBM operations.
• Intermediate to advanced skill set in MS Office, Word, Excel, PowerPoint, and Outlook. advanced skill set in MS Office, Word, Excel, PowerPoint, and Outlook.
• Producing analytical reporting and interpreting pharmacy data.

Preferred

• CPhT certification
• Experience with ticketing, project-tracking, reporting, or benefit-administration systems.

Core Competencies

• Day-to-day account coordination
• Pharmacy benefit and PBM operational knowledge
• Issue tracking and follow-through
• Benefit and eligibility support
• Implementation and change coordination
• Documentation and organizational discipline
• Service-oriented communicationEscalation judgment
• Cross-functional collaboration
• Accuracy and attention to detail
• Remote-first, distributed team; core collaboration hours with occasional travel to Mt. Laurel, NJ.
• High-ownership engineering team supporting live pharmacy operations.
• Frequent use of Python, AWS, Git, and AI development tooling.

What We Offer

• Purpose-driven culture and the opportunity to make a meaningful impact on chronic care and end-of-life care.
• Collaborative and mission-driven work environment.
• Real ownership of the features you build, and a modern, AI-first engineering practice.
• ChorusRx is committed to the well-being of our team members and offers a variety of benefits to support our employees. Full-time employees are eligible for our benefits package. Benefits include, but are not limited to health, vision, and dental insurances, PTO, and paid holidays.

ChorusRx (formerly GalenusCare) is the service brand of Chorus Healthcare, Inc. focused on delivering advanced medication management, precision analytics, and collaborative care solutions to post-acute and long-term care settings along with precision pharmacy services. We combine clinical excellence with data-driven insights to improve patient outcomes, streamline operations, and support providers with tailored pharmacy services.

Disclaimer

This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work being performed by employees assigned to this classification.

ChorusRx is proud to be an equal opportunity employer. ChorusRx will not discriminate against any employee or applicant on the basis of age, color, disability, gender political opinion, religion or belief, nationality, ethnic or social origin, sexual orientation, veteran status, physical appearance, or any classification protected by federal state, or local law. We are committed to creating a diverse and inclusive environment that supports, inspires, and respects all individuals.