Job Description
Job Title
Drug Program Specialist
Employment Type
Full-time, Permanent, Hybrid
About this opportunity
The Drug Program Specialist supports the implementation and ongoing evolution of the drug benefits claims adjudication platform. The role provides expertise in drug benefit policy, data, formularies, pricing, and pharmaceutical standards to ensure accurate adjudication, regulatory compliance, and alignment with business needs.
As the subject matter expert in drug program administration, the Specialist helps define drug plans, benefit rules, supports testing and issue resolution, and works with cross‑functional teams and external partners to shape how drug claims are adjudicated and managed.
The role also supports the Product Director by helping prioritize work, inform decisions, and elevate issues as needed.
Accountabilities
- Drug Benefits Expertise & Policy Application: Act as the internal exper...