Pharmacy Coordinator

ATD Technology LLC

United States

Job Details:

The Pharmacy Coordinator provides front line staff guidance, ensures effective and efficient delivery of Pharmacy call center services.
Serves as first line reviewer in monitoring and ensuring adherence to the health plan's state and federal multiple drug benefit design offerings.
This position responds to physician and pharmacy network provider inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior authorization medication exception requests.
Will interact with pharmacy network providers to evaluate, educate and/or assist in addressing denied point of sale prescription claim transitions and coordination of benefits practices/procedures.

Required:

High School Diploma/GED Required
Pharmacy Experience Required
Pharmaceutical Knowledge
3-5 yrs of Customer Service Required
Proficient in Microsoft Suite
Barrier Identification & Problem Solving

Preferred:

1-3 Healthcare Insurance Experience Strongly Preferred
Pharmacy Benefits Management Understanding
Bilingual (Spanish)

Skills:

Excellent computer skills such as working knowledge of Microsoft Outlook, Word, OnBase
Excellent interpersonal, communication and attentive listening skills
Strong organizational skills, detail oriented
Demonstrated excellence in communication skills
Demonstrated ability to work well with others
Demonstrated ability to work in a fast paced, multi-task environment

Assessment: Candidate MUST take "Pharmacy Coordinator" Glider assessment.

Apply

Vacancy posted 1 day ago

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