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Pharmaceutical Care Specialist

2 months ago

Morris Plains, New Jersey, United States Cigna Full time
Position Overview:

The Clinical Pharmacist plays a vital role in the operational framework of a leading global health insurance provider. This temporary role involves executing designated operational tasks utilizing standard tools such as Siebel, BA, Clinical Rules Platform, and Coverage Benefits, while also addressing client inquiries under the guidance of Managers and team members.

Key Responsibilities:

  • Support service transactions aligned with business requirements, including assistance to business partners and internal teams.
  • Manage daily request tracking, investigate operational challenges, and generate reports for both internal and external stakeholders upon request.
  • Document the completion of assigned tasks and escalate issues, risks, or concerns as necessary.
  • Adapt to an agile, flexible shift model, which includes supporting the 2nd shift schedule (12-8 pm EST) and weekends to fulfill business and operational objectives.

Department Mission:
The Client Benefit Services department is dedicated to meeting market demands for speed, flexibility, and reliability, while promoting best operational practices to enhance the company's competitiveness and effectiveness in the marketplace.

Job Functions:

  • Accurately assess and configure benefit intent.
  • Collaborate with internal partners to ensure comprehensive understanding and communication of clinical benefit requirements.
  • Ensure timely and precise translation of client intent into relevant clinical systems.
  • Monitor and communicate the status of service requests as needed.
  • Engage with business partners to clarify clinical benefit requirements and analyze new requests against existing setups.
  • Assist team members with issue resolution post-implementation.
  • Translate requirements into internal requests for vendors and manage all requests to meet timelines, including proactive management of client-specific performance guarantees.
  • Communicate completed benefit notifications to clients with accurate documentation.
  • Conduct random reviews of work completed by coding teams and develop an understanding of associated clinical applications.
  • Act as a resource in the development and maintenance of the 'Client Benefits' system.

Qualifications:

  • RPh or PharmD preferred.
  • Current RPh Licensure in good standing as required by the state of employment.
  • Proficient in Microsoft Office, particularly Excel and Access.
  • Strong written and verbal communication skills, including listening, feedback, and the ability to translate complex ideas.
  • Demonstrated collaboration, analytical thinking, critical thinking, results-oriented mindset, and organizational skills.

Location and Schedule:
This position is fully remote and open to candidates across the United States. The applicant is expected to work in an agile, flexible shift model, including the 2nd shift schedule (12-8 pm EST) and weekends to meet business and operational deliverables.

Compensation:
The anticipated pay range for this position is $38.79-$51.72/hr, depending on location and experience. Benefits include Medical, Dental, Vision, and 401K, provided minimum eligibility hours are met.