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Pharmacy Benefit Coordinator

4 months ago

Canton, United States Point32Health Full time

Pharmacy Benefit Coordinator is responsible for review and resolution of benefit and eligibility issues, accurate and timely creation of member level overrides of plan coverage in the RxClaims System for all lines of business within Point32Health.

Position will be remote, except for 1 day a calendar quarter in the Canton, MA office, as well as 1 day/week extended shift 11:30am - 8pm.

Key Responsibilities/Duties what you will be doing

  • Acts as the primary customer service/policy contact on member level benefit and eligibility issues
  • Executes member level overrides of plan coverage in the RXCLAIM system
  • Identifies and resolves problems associated with member requests
  • Assists partner departments with pharmacy operation questions and triage questions to/from PBM as necessary
  • Provides a variety of administrative functions to support the pharmacy program
  • Participates in meetings as required by the department Manager and Supervisor
  • Performs other related duties as assigned by the Supervisor, Pharmacy Operations

Qualifications what you need to perform the job

  • High School Diploma or equivalent required, Bachelor's Degree preferred
  • Pharmacy experience required; knowledge of pharmacy services and pharmacy terms required
  • Registered Pharmacy Technician preferred; Certified Pharmacy Technician preferred
  • One to three years experience in a health care setting required, preferably customer service setting

Commitment to Diversity, Equity & Inclusion

Point32Health is committed to making diversity, equity, and inclusion part of everything we dofrom product design to the workforce driving that innovation. Our DEI strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities.

This job has been posted by Ignyte AI on behalf of Point32Health. Ignyte AI is committed to the fundamental principle of equal opportunity and equal treatment for every prospective and current employee. It is the policy of Ignyte AI not to discriminate based on race, color, national or ethnic origin, ancestry, age, religion, creed, disability, sex and gender, sexual orientation, gender identity and/or expression, military or veteran status, or any other characteristic protected under applicable federal, state or local law.

Req ID: R7987