PBM Clinical Operations Associate

Benecard Services, LLC; Town of Florida (NY); On-site; USD 52,000 - 70,000; Full time

Benefits offered by this job

Vacation time

Medical Insurance

Disability Insurance

Life Insurance

401(k)

Tuition Reimbursement

Professional Development Training

Employee Recognition

Employee Referral Program

Job summary

Benecard Services, LLC seeks a detail-oriented Clinical Operations Associate to support clinical and operational processes for PBM services. Candidates with pharmacy technician or managed care backgrounds are encouraged to apply, delivering accurate documentation and timely notifications.

The role involves reviewing requests, interacting with pharmacies and prescribers, and handling multiple tasks in a fast-paced environment while maintaining excellent customer service and regulatory compliance.

Qualifications

• High school diploma or equivalent required.
• Experience in healthcare, pharmaceutical services, managed care or clinical operations preferred.
• Proficiency with Microsoft Office (Excel/Word) and ability to learn new software.
• Excellent verbal and written communication in English; strong organizational skills.

Responsibilities

• Review and process clinical requests from pharmacies, providers, members and stakeholders.
• Communicate with pharmacies, prescribers, and members by phone to obtain information.
• Review prior authorization submissions and data verification requests.
• Enter overrides and process clinical determinations in system platforms.
• Generate and distribute decision letters and required documentation.
• Maintain accurate records and comply with policies and regulatory requirements.
• Support additional duties and special projects as assigned.

Skills

Communication

Multitasking

Organizational skills

Customer service

Education

High school diploma or equivalent

Tools

Microsoft Office

Excel

Word

Job description

Benecard Services, LLC seeks a detail-oriented Clinical Operations Associate to support clinical and operational processes for PBM services. Candidates with pharmacy technician or managed care backgrounds are encouraged to apply, delivering accurate documentation and timely notifications.

The role involves reviewing requests, interacting with pharmacies and prescribers, and handling multiple tasks in a fast-paced environment while maintaining excellent customer service and regulatory compliance.