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Pharmacy Benefits Manager

2 months ago

Woonsocket, Rhode Island, United States Adecco USA Full time
Job Summary

Adecco USA is currently seeking a highly skilled and experienced Pharmacy Benefits Manager to join our team. As a key member of our team, you will be responsible for managing pharmacy benefits, processing claims, and providing exceptional customer service to our clients.

Key Responsibilities
  • Manage Pharmacy Benefits: Utilize multiple software systems to complete Medicare appeals case reviews, meeting or exceeding government mandated timelines.
  • Process Claims: Comply with turnaround time, productivity, and quality standards, conveying resolution to beneficiaries or providers via direct communication and professional correspondence.
  • Acquire and Maintain Knowledge: Acquire and maintain basic knowledge of relevant and changing Med D guidance.
Requirements
  • Education: High School Diploma or GED required.
  • Experience: 2-3 years of recent experience managing calls regarding pharmacy benefits, with a strong attention to detail and excellent verbal and written communication skills.
  • Technical Skills: MS Office proficiency, including Word, Excel, Teams, and Outlook, as well as strong knowledge of pharmacy benefits and Medicare appeals processes.
Work Environment

This is a remote position, and you will be working from home. You will need to provide your own high-speed internet connection, with a minimal home broadband connectivity speed of 25 mb download and 3 mb upload speed. You will also need a smartphone and a dedicated workspace that is not accessible by others.

Benefits

Adecco USA offers a comprehensive benefits package, including medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits, and a 401K plan. Our benefits package provides employees with the flexibility to choose the type of coverage that meets their individual needs.