Lead Pharmacy Operations Specialist

A company is looking for a Lead Pharmacy Systems Operations Specialist.

Key Responsibilities

Manage and support pharmacy claims adjudication across multiple platforms

Develop and maintain standard operating procedures for adjudication processes

Ensure compliance with regulatory requirements and conduct audits for accuracy

Required Qualifications

8+ years of experience in the pharmacy sector or equivalent practical experience

Understanding of pharmacy claim adjudication and pricing rules

Proficiency in pharmacy claims systems and EDI transactions

Strong SQL and Excel proficiency, or other data analysis / reporting tools preferred

Experience working with Power BI or Looker is preferred