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Position Title: Pharmacy Coordinator 1
Work Location: Remote – Nationally sourced
Assignment Duration: 6 months
Work Schedule: Monday – Friday (8 AM to 4:30 PM). No overtime and we can be flexible on the start/end time.
Work Arrangement: Remote
Position Summary:
• Perform duties to support the efforts pharmacy department in the development, coordination and maintenance of the health plan's pharmacy program.
Key Responsibilities:
• Receive and respond to provider and pharmacy calls regarding the prior authorization and formulary process
• Perform review of pharmacy and override process in compliance with pharmaceutical related company and State guidelines
• Track and trend overrides to ensure criteria have been met, audit for prior authorizations, analyze cost and determine utilization patterns
• Resolve complaints and grievances related to the pharmacy network in conjunction with the Pharmacy team
• Assist Provider Relations and various departments with educating providers on the health plan’s pharmacy process
• Assist with the pharmacy utilization review and reporting process
• Collaborate with Quality Improvement department with various meeting preparation and transcription of minutes
• Assist with members’ inquiries related to the formulary process
• Performs other duties as assigned
• Complies with all policies and standards
Qualification & Experience:
• High school diploma or equivalent.
• 3+ years of pharmacy experience, preferably in a managed care environment.
• Medicare and/or Medicaid experience preferred.
• Prior experience using analysis tools or systems (ex: web based, custom, proprietary, etc.).
• Experience in the implementation of quality process improvement efforts.
• Experience documenting requirements, creating training materials and working directly with end users.
• License/Certificate: Current state's Pharmacy Technician license preferred.
| Candidate Requirements | ||||
| Education/Certification | Required: high school diploma | Preferred: | ||
| Licensure | Required: | Preferred: prefer a Pharmacy Technician License but not required. | ||
| Years of experience required: 3+ years of Pharmacy Technician experience (open to PBM, retail, or other various experience) Disqualifiers: Additional qualities to look for: Ability to multitask or properly prioritize work, Experience with projects or assignments that require attention to details. | ||||
| 1 | Pharmacy Technician experience (open to PBM, retail, or other various experience) | ||
| 2 | Microsoft Office Experience – Excel, Word, Outlook, Visio | |||
| 3 | Ability to work independent and keep good communication with about their project/assignment updates. | |||