Plan Administration Specialist

Description:

Position Overview: The Plan Administration Specialist applies strong analytical and problem-solving skills to review plan data, resolve configuration issues, and collaborate with internal teams to ensure smooth operations.

About MedOne: MedOne is a full-service pharmacy benefit manager (PBM), serving clients and members nationwide. With a fully transparent, pass-through model, MedOne helps people conveniently access the most appropriate prescriptions at the most affordable price.

What You'll Do:

• Support the PLAD team with implementation efforts, including plan-building activities within the claims adjudication system for new and existing clients.
• Assist with testing plan builds, system changes, and program modifications while documenting testing results.
• Assist with testing software releases. This includes both regression testing and software enhancements.
• Maintain accountability for timely resolution of configuration errors.
• Monitor claims for processing errors.
• Research and respond to claim inquiry questions.
• Assist with documenting, building, maintaining, and testing pharmacy networks.
• Assist with recording processes and documentation to support the PLAD team and Business Architecture.
• Educate others on system capabilities, system implementation approach, and test results.
• Cultivate positive relationships and collaborate effectively with internal teams.
• Participate in ongoing professional development to stay updated on the latest Pharmacy Benefits Management (PBM) products and services.
• Perform other duties as assigned by the supervisor.

What You Will Bring to MedOne:

• Associate’s degree or equivalent work experience
• 1–3 years of experience in a Pharmacy Benefits Management (PBM) environment, with preferred experience in claims processing systems, plan design system implementation, or pharmacy network system management
• Exceptional critical thinking and problem-solving skills
• Exceptional organizational, time management, and multitasking skills
• Proficiency in Microsoft Office products (Word, Excel)

Why MedOne? At MedOne, we believe that a healthy team is a happy team. We offer a collaborative work environment, competitive benefits, and opportunities for growth—all while helping to make a difference in people’s lives. Our top core value is to prioritize your well-being. To support you in living this value, we offer:

• Competitive salary and bonuses that reward your performance.
• Comprehensive health, dental, and vision insurance + additional benefits
• 401(k) with company match to secure your future.
• Generous paid time off and holidays.
• Opportunities for professional growth and development.
• A vibrant and collaborative work culture.

Location: We have offices in Dubuque, IA and Kansas City, KS; however, we are open to fully remote candidates within the United States.

Employment Type: Full Time, Salaried/Exempt Position

Reports to: Supervisor of Plan Administration

How to Apply: If you're enthusiastic about helping others and eager to join a dynamic team, we’d love to hear from you. Apply now and take the first step toward a rewarding career at MedOne! You can submit your application through our careers page.

MedOne is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Job Offers are contingent on passing a background check and drug screen.

Requirements: