Pharmacy Benefits Operations Consultant

Pharmacy Benefits Operations Consultant will serve as a liaison across pharmacy benefits, CCS, COB, and related payer relationships, coordinating project reporting, analyzing operational impacts, and resolving benefit coordination issues involving Medi-Cal, Medicare, Medicare Advantage, and managed care plans. The role requires applying Medicare/Medicare Advantage knowledge to support COB processes, claims routing, and regulatory alignment, and will involve facilitating meetings, documenting decisions, validating business rules, and providing actionable recommendations to leadership and stakeholders to ensure compliance with CMS guidance and state program requirements.