PBA Account Operations Specialist

Position Summary

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.

Collaboration

• 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 communication
• Escalation judgment
• Cross-functional collaboration
• Accuracy and attention to detail

Working Environment

• 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.