About the Company
Aetna, a CVS Health company, is one of the nation’s leading diversified health care benefits companies. We provide individuals, employers, health care professionals, producers and others with innovative benefits, products and services. Our mission is to build a healthier world by making health care more accessible, simpler, and more affordable. Joining Aetna means becoming part of a team dedicated to improving lives and shaping the future of health.
Job Description
We are seeking a diligent and detail-oriented Pharmacy Benefits Coordinator to join our Human Resources and Insurance Administration team in Oklahoma City. In this pivotal role, you will be responsible for administering pharmacy benefits programs, ensuring compliance with plan designs, and providing exceptional support to our employees regarding their pharmacy coverage. This position requires strong organizational skills, an understanding of healthcare benefits, and the ability to communicate complex information clearly and empathetically. You will act as a key liaison between employees, pharmacy benefit managers (PBMs), and our internal HR department.
Key Responsibilities
- Administer and oversee the day-to-day operations of employee pharmacy benefit programs.
- Serve as the primary point of contact for employee inquiries regarding pharmacy benefits, claims, and coverage issues.
- Collaborate with Pharmacy Benefit Managers (PBMs) to resolve claims disputes, formulary questions, and ensure seamless service delivery.
- Educate employees on their pharmacy plan options, deductible status, co-pays, and out-of-pocket maximums.
- Assist with the enrollment and termination processes for pharmacy benefits, ensuring accurate data entry and record-keeping.
- Review and reconcile pharmacy benefit invoices for accuracy and process payments in a timely manner.
- Stay current with changes in pharmacy regulations, industry trends, and company benefit policies.
- Prepare regular reports on pharmacy utilization, costs, and employee engagement.
- Participate in annual open enrollment processes, including preparing communication materials and conducting informational sessions.
- Maintain strict confidentiality of all employee health information and adhere to HIPAA guidelines.
Required Skills
- 2+ years of experience in benefits administration, HR support, or a related healthcare administrative role.
- Demonstrated understanding of pharmacy benefits, including formularies, co-pays, deductibles, and PBM operations.
- Excellent verbal and written communication skills, with the ability to explain complex benefit information clearly.
- Strong analytical and problem-solving abilities to resolve benefit issues and discrepancies.
- Proficiency in Microsoft Office Suite (Excel, Word, Outlook).
- High level of attention to detail and accuracy in managing data and records.
- Ability to work independently and as part of a team in a fast-paced environment.
- Exceptional customer service skills and a compassionate approach to employee interactions.
Preferred Qualifications
- Bachelor's degree in Human Resources, Business Administration, Healthcare Administration, or a related field.
- Experience working with HRIS and benefits administration systems (e.g., Workday, SAP SuccessFactors).
- Knowledge of HIPAA regulations and other relevant healthcare compliance standards.
- Certification in HR (e.g., PHR, SHRM-CP) or Benefits Administration (e.g., CEBS).
Perks & Benefits
- Competitive salary and performance-based bonuses.
- Comprehensive health, dental, and vision insurance plans.
- 401(k) retirement plan with company matching.
- Generous paid time off, including holidays and vacation.
- Employee assistance programs and wellness initiatives.
- Opportunities for professional development and career growth.
- Tuition reimbursement program.
- On-site fitness center or discounted gym memberships.
How to Apply
If you are interested in this position, please click the "Apply Now" button below. To ensure your application is properly considered, please prepare the following:
- An up-to-date Resume or CV
- A brief cover letter summarizing your experience and motivation
Applications are reviewed on a rolling basis. Only shortlisted candidates will be contacted for an interview.
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