Senior Pharmacy Benefits Coordinator (Hybrid/Remote)

WPS—A health solutions company; Nebraska; Hybrid; USD 75,000 - 78,000; Full time

Benefits offered by this job

Remote and hybrid work

Performance bonus

401(k) with match

PTO and holidays

Health/dental/telehealth from Day 1

Leadership development

Job summary

WPS—A health solutions company in Madison, WI, is seeking a Pharmacy Coordinator to oversee audit processes and PBM system capabilities. You will support internal teams and resolve escalated customer issues with independent judgment.

The role requires 5+ years in a pharmacy benefits role, strong analytical skills, and solid knowledge of PBM operations. The position supports hybrid work arrangements and remote options across approved states.

Qualifications

• 5+ years in a Pharmacy Benefit role for a health insurer or PBM.
• Knowledge of health benefits concepts and PBM operations.
• Understanding of pharmacy claims processing and formulary management.
• Excellent communication and relationship management skills.
• Ability to manage multiple priorities and analyze data.

Responsibilities

• Serve as SME for pharmacy benefits and system capabilities, guiding internal teams.
• Interpret claims data, identify trends, and act on issues.
• Decide on PBM operational needs and monitor performance.
• Collaborate with Call Center, Sales, Account Management, Marketing, and Health Services.
• Coordinate PBM employer group reporting and external discussions.
• Work with Risk Management on high-cost claims and denials.
• Assist Plan Product with PBM system updates and configurations.
• Coordinate with PBM and vendors for QIC materials and audits.
• Quantify savings and outcomes for pharmacy programs.
• Other duties as assigned.

Skills

Pharmacy benefits expertise

Data analysis

Stakeholder communication

Regulatory awareness (URAC CMS)

Problem solving

Education

Associate degree or higher in business/healthcare

Job description

WPS—A health solutions company in Madison, WI, is seeking a Pharmacy Coordinator to oversee audit processes and PBM system capabilities. You will support internal teams and resolve escalated customer issues with independent judgment.

The role requires 5+ years in a pharmacy benefits role, strong analytical skills, and solid knowledge of PBM operations. The position supports hybrid work arrangements and remote options across approved states.