Pharmacy Benefit Technical Specialist

3 weeks ago

Albany NY United States CAPITAL DISTRICT PHYSICIANS HEALTH PLAN INC Full time

Grounded by a compelling mission, core values, and compassion for people, CDPHP and its family of companies offer a strong foundation for a rewarding career. Established in 1984, CDPHP is a physician-founded, member-focused, and community-based not-for-profit health plan that offers high-quality affordable health insurance to members throughout New York. The company values people, quality, innovation, and community, and its corporate culture supports those values wholeheartedly. CDPHP is committed to fostering a culture of belonging and takes a wholistic approach to diversity, equity, and inclusion. At CDPHP, the employees have a voice and are encouraged to make an impact at both the company and community levels through engagement and volunteer opportunities. CDPHP invests in employees who share these values and invites you to be a part of that experience.

The information below covers the role requirements, expected candidate experience, and accompanying qualifications.

The Pharmacy Benefit Technical Specialist is responsible for implementing and monitoring the technical aspects of pharmacy benefits. This individual implements medical exception/prior authorization decisions made by Pharmacists and/or Managed Care Pharmacy Technicians. Specialists will be responsible for answering calls from a pharmacy phone queue, advising on pharmacy matters from internal and external sources, as well as additional ad hoc project work which supports the pharmacy department.

QUALIFCATIONS:

Associates degree required. 2 years relevant experience may be substituted for degree.
Minimum 1 year of experience in health care/managed care related field required.
Minimum one (1) year in pharmacy service is preferred.
Experience with Microsoft Office, including Word, Excel, Outlook and PowerPoint is required.
Demonstrated ability to work with system support customers as well as interfacing with IT personnel to solve problems as required.
Demonstrated ability to pro-actively identify problems, as well as recommend and/or implement effective solutions.
Must be detail-oriented with strong organizational skills, including the ability to coordinate workflow.
Excellent verbal and written communication skills
Flexibility to adapt to a changing and fast-paced environment.
Demonstrated ability to work with and maintain confidential information.
Demonstrated ability to provide excellent customer service and develop relationships both internally and externally.
Ability to work additional hours as needed in order to meet turnaround time responsibilities.

As an Equal Opportunity / Affirmative Action Employer, CDPHP will not discriminate in its employment practices on the basis of race, color, creed, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, protected veterans status, or any other characteristics protected under applicable law. To that end, all qualified applicants will receive consideration for employment without regard to any such protected status.

CDPHP and its family of companies include subsidiaries Strategic Solutions Management Consultants (SSMC), Practice Support Services (PSS), and ConnectRx Services, LLC.

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