Senior Pharmacy Support Specialist

Job Description

Job Description

Description:

Position Summary

The Senior Pharmacy Support Specialist is responsible for providing day to day leadership and operational support to the Pharmacy Support Specialist team. This role serves as the first point of contact for escalations and complex cases, offering guidance and resolution while escalating to Clinical Pharmacists and management as necessary. The Senior PSS also mentors and coaches team members to ensure consistent performance and skill development. Key responsibilities include leading onboarding and training initiatives, developing ongoing training resources, and ensuring team proficiency. The Senior PSS also handles complex member and client concerns. Additionally, this role contributes to and may lead special projects and operational initiatives.

Team Leadership & Mentorship:

• Serve as the first point of contact and escalation for Pharmacy Support Specialist team members regarding operational questions, complex cases, procedural clarifications, and troubleshooting.
• Resolve Pharmacy Support Specialist-related issues independently whenever possible, or escalate effectively to the manager with necessary context and potential solutions.
• Mentor, coach, and provide guidance to Pharmacy Support Specialist team members to foster skill development and consistent performance.
• Serve as the trusted partner of the Manager of Pharmacy Operations in supporting day-to-day operations and seamless execution, including anticipating and suggesting solutions to client and team member challenges

Training & Development:

• Lead the onboarding and training process for new Pharmacy Support Specialist hires, ensuring they are proficient in procedures, systems (including Google Workspace and relevant PBM platforms), and TruCardRx/TruDataRx product knowledge.
• Identify ongoing training needs; develop and deliver training sessions or materials to address process updates, system changes, or skill gaps within the team.
• Support recruitment of new team members

Core Pharmacy Support Specialist Functions:

• Handle escalated or complex inbound member/client concerns, ensuring effective resolution and documentation.
• Oversee and contribute to administrative tasks related to prior authorizations (PA) and appeals, ensuring accuracy and efficiency.
• Provide expert support to the clinical team during PA case reviews and assist with complex outbound member/provider calls.
• Contribute to and potentially lead special projects and operational tasks as assigned.

Qualifications and skills:

• High school diploma or equivalent required; Associate’s or Bachelor’s degree in healthcare, business, or related field preferred
• Competitive candidates will have a minimum of 2 years experience in PBM operations, including medical necessity or prior authorization case reviews; Candidates without PBM experience will be considered if they have equivalent leadership experience, e.g. team lead or trainer, or experience with special projects, e.g. inventory management
• Minimum of 1 year of experience in a leadership, mentorship, or training capacity preferred
• Proven ability to resolve complex issues and make sound decisions independently
• Fast learner and interested in potential growth opportunities as the product roles expand
• Excellent verbal and written communication skills a must
• Pharmacy technician experience preferred
• PBM experience preferred
• A track record of fostering collaboration, resolving conflicts, and managing projects is preferred.
• Excellent technical skills in Google Work products (Docs, Drive, Slides) and Microsoft (Word, PPT, Excel)