![Maryland Physicians Care](https://media.trabajo.org/img/noimg.jpg)
Pharmacy Benefit Coordinator
1 month ago
The Pharmacy Benefit Coordinator is responsible for supporting clinical outreach services to our members, their pharmacies, and their healthcare providers to ensure member safety, minimize gaps in care, identify cost-effective medication strategies, and coordinate care to improve healthcare outcomes for our members. The position will support HEDIS adherence initiatives and work to support longitudinal improvement goals.
In addition, the Pharmacy Benefit Coordinator performs a variety of routine to moderately complex administrative and pharmacy-related tasks that support the Pharmacy Management team within the department. The Pharmacy Management team is responsible for managing the pharmacy benefits for Maryland Physicians Care in collaboration with the pharmacy benefit management (PBM) vendor and the organization's utilization review, quality improvement, provider relations, and population health initiatives.
About Maryland Care Management, Inc. (MCMI)
Maryland Care Management, Inc. (MCMI) manages Maryland Physician Care's (MPC) statewide provider network of hospitals and physicians. Maryland Physicians Care has been providing services to the HealthChoice Medicaid populations since 1996, and we are proud of our footprint in the community. With over 230,000 members, MPC consistently has been one of MD's largest Medicaid-managed care organizations.
Why join us?
MCMI recognizes the importance of flexibility and offers multiple work arrangements. Along with competitive pay, we offer excellent benefits (medical, dental, and vision plans, 100% employer Term Life Insurance, Short and Long-Term Disability, 401k Employer Match up to 4%) as well as 20 days of PTO, and tuition assistance/professional development plans.
Your future colleagues at MCMI are welcoming, friendly, and eager to help each other succeed. We are committed to Diversity, Equity, and Inclusion, providing organizational-wide social opportunities, and constantly improving our ongoing efforts to impact our members' lives positively.
What You'll Do:
- Work collaboratively with quality management to support HEDIS adherence projects.
- Support the accurate implementation and coding of pharmacy benefits, formulary, and program changes, including review of PBM testing scenarios.
- Review pharmacy services recommended for denial. Of those recommendations, investigate and review data and information retrieved from plan providers.
- Assist in the management of members by collecting pertinent information from plan providers and other pharmacy data systems.
- Assist in various pharmacy, utilization review/management, quality improvement, provider relations, and population health initiatives.
- Serve as a pharmacy liaison and resource person to plan pharmacies and members.
- Assist the Pharmacist with monitoring and evaluation of pharmacy utilization.
Knowledge and Skills:
- Thorough understanding of prescription benefit management (PBM) programs and practices.
- Ability to identify, communicate findings, and resolve member, provider, process, and system issues, communicating recommendations verbally and in writing.
- Business writing and presentation skills, including writing reports.
- Excellent attention to detail, including but not limited to interpretation and understanding of benefits/codes.
- Familiarity with government relations with the ability to operationalize and understand how various aspects of regulation are interdependent and related.
- High School diploma/ GED, or equivalent.
- Current Maryland State Pharmacy Technician licensure, including certification from a nationally recognized Pharmacy Technician Certification Board.
- Minimum two (2) years of experience as a pharmacy technician.
- Experience working in a managed care, insurance, PBM, or equivalent environment is strongly preferred.
- Experience supporting utilization management/prior authorization processes.
EEOC Statement:
Following applicable federal, state, and local laws, MCMI prohibits discrimination in employment based on race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age, disability, genetic information, or any other characteristic protected by law. This commitment extends to all aspects of employment, including hiring, promotion, compensation, benefits, training, social and recreational programs, and all other conditions and privileges of employment.
As a healthcare organization, we recognize the vital importance of inclusivity in delivering quality care to our patients. We strive to foster an environment where individuals of all backgrounds feel respected, valued, and supported. We aim to better comprehend the unique needs of our patients and provide healthcare services that are culturally competent and sensitive.
We encourage candidates from all backgrounds to apply and join us in our mission to provide compassionate and inclusive healthcare. We believe that a diverse workforce enriches our organization and allows us to better understand, connect with, and serve our diverse patient population.
-
Benefits Coordinator
1 month ago
Maryland, United States EA Engineering, Science, and Technology Full timeWe have an exciting opportunity for a Benefits Coordinator to join our Human Resources team in our Hunt Valley, MD office. This position will be hybrid remote. What you will do: As a Benefits Coordinator, you will administer and provide subject matter expertise to employees on EA’s comprehensive benefits package which includes health insurance, life...
-
Benefits Coordinator
3 weeks ago
Maryland, United States EA Engineering, Science, and Technology Full timeWe have an exciting opportunity for a BenefitsCoordinator to join our Human Resources team in our Hunt Valley, MD office.This position will be hybrid remote. What you will do: As a Benefits Coordinator, you will administer and provide subject matter expertise to employees on EA’s comprehensive benefits package which includes health insurance, life...
-
Psychiatric Clinical Pharmacist II
2 months ago
Maryland Line, United States Syntricate Technologies Full timeDescription: Psychiatric Clinical Pharmacist II Direct Hire May go hybrid after training - Will be hybrid 3 days in 2 off Critical Personnel A. Required Qualifications: 1) Minimum of three (3) years of experience in supporting formulary, PA, benefits design, and clinical information. 2) Pharm.D with current active Pharmacist license in Maryland (or shall be...
-
Psychiatric Clinical Pharmacist II
2 months ago
Maryland Line, United States Syntricate Technologies Full timeDescription: Psychiatric Clinical Pharmacist II Direct Hire May go hybrid after training - Will be hybrid 3 days in 2 off Critical Personnel A. Required Qualifications: 1) Minimum of three (3) years of experience in supporting formulary, PA, benefits design, and clinical information. 2) Pharm.D with current active Pharmacist license in Maryland (or shall...
-
Coordination of Benefits Specialist
4 weeks ago
Maryland Heights, Missouri, United States Magellan Health Full timeResponsible for updating COB records in all claims systems as well as determining order of benefits.Coordination of positive COB responses with the Cost Containment staff will be necessary for recovery purposes.This position is responsible for updating Coordination of Benefits (COB) records in all claims systems as well as determining order of benefits....
-
Specialty Pharmacy Technician
2 weeks ago
Elkridge, Maryland, 21075, Anne Arundel County, MD, United States MEDSTAR HEALTH Full timeGeneral Summary of PositionAssists the Pharmacist(s) in all areas of pharmacy operations, including data entry, product dispensing, and packing of prescription orders in a high-volume fulfillment and / or call center environment on a multidisciplinary team. The position requires routine interaction with in clinic liaisons, pharmacists, and providers, as well...
-
Pharmacy Technician II
2 weeks ago
Leonardtown, Maryland, 20650, St. Mary's County, MD, United States MEDSTAR HEALTH Full timeGeneral Summary of PositionUnder the direct supervision of a pharmacist, assists in performing routine technical duties such as compounding, packaging, distribution, IV admixtures, electronic order entry, inventory control, and storage of pharmaceutical items. Fills routine orders for nonprescription pharmaceuticals Primary Duties and Responsibilities...
-
Surgery - Vascular
3 months ago
Maryland Line, United States Delta Physician Placement Full timeCOMPENSATION AND BENEFITS Vascular Surgery (MD/ DO) Realistic income potential of $600K+ Guaranteed salary of $500K + production compensation model Full Benefits including 4 Weeks PTO, 5 Days / $2,000 CME allowance, 3% retirement-match $25,000 signing bonus RESPONSIBILITIES AND FACILITY DETAILS Vascular Surgery (MD/ DO) Monday - Friday; 8:30am - 4:30pm No...
-
Sr. Program Management Operations Analyst
2 months ago
Maryland Line, United States NSS Full timeSenior Program Management Operations Analyst Fibertek is a leading developer of laser and electro-optic systems for the aerospace community, with key contributions to lasers for atmospheric sensing, laser communications, and lidar sensors for NASA, DoD, and commercial customers. We are looking for a highly motivated individual to join our division at the...
-
Analyst, Financial Systems
4 weeks ago
Maryland Line, United States T Rowe Price Group, Inc Full timeRequisition Number: 72289 Position Title:External Description: ABOUT THIS POSITION Financial Systems Analyst is responsible for leading the testing and implementation of automated financial information systems and updates related to assigned ERP (Enterprise Resource Planning), EPM (Enterprise Performance Management) and other financial systems....
-
Sanitation and Solid Waste Project Manager
1 week ago
Maryland Line, United States Sterile Services Co Full timeLocation: Silver Spring, MD Position Summary: We seek a dedicated and experienced Sanitation and Solid Waste Project Manager to join our team part-time. The successful candidate will oversee and coordinate various sanitation and solid waste management projects, ensuring they are completed efficiently, on time, and within budget. This role requires a...
-
Registered Nurse
2 weeks ago
Maryland Line, United States Amedisys Full timeOverview $[Insert sign-on bonus amount] sign-on bonus [Insert shift Ex: Full-time days] Are you a highly skilled and compassionate registered nurse (RN) looking for a rewarding career in ho spice as an admissions nurse ? If so, we invite you to join our team at Amedisys, one of the largest and most trusted h ome health and hospice companies in the U.S....
-
Lead Fixed Income Portfolio Investment Analyst
2 months ago
Maryland Line, United States T Rowe Price Group, Inc Full timeRequisition Number: 71644 Position Title:External Description: SCOPE The Lead Portfolio Investment Analyst (PIA) resides within the Investment and Trading Solutions group and is a member of the Global Trading team. The Lead PIA works directly alongside portfolio managers and traders to assist with the day-to-day portfolio implementation and management of...
-
Physical Therapist- Skilled Nursing
1 day ago
Maryland Line, United States Theradynamics Full timePhysical Therapist (PT) Needed at a Skilled Nursing Facility in Maryland! Theradynamics is proud to be recognized as one of the leading contract rehabilitative therapy companies in the Tri-State area. For more than 16 years, we have been working closely with the patients in helping them achieve their goals through creative treatments and state of art...
-
Visiting Occupational Therapist
4 weeks ago
Maryland Line, United States Adventist HealthCare Full timeAHC - Home Health Southern Maryland If you are a current Adventist HealthCare employee, please click this link to apply through your Workday account. Adventist HealthCare Home Health seeks to hire an Occupational Therapist (OT) who will embrace our mission to extend God's care through the ministry of physical, mental and spiritual healing with a sign on...
-
Senior Analyst, Middle Office Margin Services
2 months ago
Maryland Line, United States T Rowe Price Group, Inc Full timeRequisition Number: 72095 Position Title:External Description: About This Role: Provides oversight and operational support for the margining and collateral management of T. Rowe Price derivatives and other complex instruments. Responsible for monitoring daily counterparty exposures, margin call activity and margin settlements. Coordinates margin activity...
-
Visiting Speech Language Pathologist
4 weeks ago
Maryland Line, United States Adventist HealthCare Full timeAHC - Home Health Southern Maryland If you are a current Adventist HealthCare employee, please click this link to apply through your Workday account. Adventist HealthCare Home Health is seeking a Speech Language Pathologist (CCC-SLP) who will embrace our mission to extend God's care through the ministry of physical, mental and spiritual healing. As a Speech...
-
Maryland Line, United States Adventist HealthCare Full timeAHC - Home Health Southern Maryland If you are a current Adventist HealthCare employee, please click this link to apply through your Workday account. Adventist HealthCare is hiring a full-time Home Health Physical Therapist (PT) in our Prince George County, with a sign-on bonus of up to $12,000. We're seeking a Physical Therapist (PT) who will embrace our...
-
Physical Therapist
2 weeks ago
Maryland Line, United States TotalMed Staffing Full timePhysical Therapist Job ID #1579582 | Share About this Role As a Physical Therapist, your responsibility involves assessing and treating patients. You will develop personalized plans tailored to achieve specific physical therapy goals. Collaboration with the Physical Therapist team ensures optimal patient progress. Job details $2,019.60 / week ...
-
Physical Therapist
3 days ago
Maryland Line, United States TotalMed Staffing Full timePhysical Therapist Job ID #1599513 | Share About this Role As a Physical Therapist, your responsibility involves assessing and treating patients. You will develop personalized plans tailored to achieve specific physical therapy goals. Collaboration with the Physical Therapist team ensures optimal patient progress. Job details $2,019.60 / week ...