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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 organization. This temporary role involves utilizing standard tools such as Siebel, BA, Clinical Rules Platform, and Coverage Benefits to support client inquiries under the guidance of management and team members.

Key Responsibilities:

  • Assist in service transactions related to business needs, including support for business partners and internal teams.
  • Manage daily request tracking, investigate operational challenges, and generate reports for both internal and external stakeholders as needed.
  • Document the completion of assigned tasks and provide team support while escalating issues, risks, and concerns as necessary.

The successful candidate will be expected to operate within an agile and flexible shift model, which includes supporting a second shift schedule (12-8 pm EST) and weekends to fulfill business and operational objectives.

Department Mission:
The Client Benefit Services department is dedicated to addressing market demands for speed, flexibility, and reliability while promoting best operational practices to enhance the company's competitive edge.

Job Functions:

  • Accurately assess and configure benefit intentions.
  • Collaborate with internal partners to ensure comprehensive understanding and communication of clinical benefit requirements.
  • Ensure timely and precise translation of client intentions into appropriate 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.
  • Provide assistance to team members in resolving issues 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 documentation of accurate setups.
  • 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 practice.
  • Proficient in Microsoft Office, particularly Excel and Access.
  • Strong written and verbal communication skills, including active listening and feedback.
  • Ability to translate complex ideas and processes, along with strong analytical and critical thinking skills.
  • Results-oriented with excellent organizational abilities.

Location and Schedule:
This role is fully remote and open to candidates nationwide. The applicant must be prepared to work in an agile, flexible shift model, including a second shift schedule (12-8 pm EST) and weekends to meet business and operational deliverables.

Compensation:
The hourly pay rate range for this position is $38.79-$51.72, depending on location and experience. Benefits include medical, dental, vision, and 401K, provided minimum eligibility hours are met.