Pharmacy Operations Representative CPhT

3 weeks ago


Albuquerque, New Mexico, United States Health Care Service Corporation Full time
Job Summary

As a valued member of our Pharmacy Medicare team, you will be responsible for providing assistance to the customer service team, pharmacy coordinators, pharmacists, and members in resolving various pharmacy claims, pricing, and coding issues.

Key Responsibilities:
  • Work with internal departments and external vendors to evaluate and resolve pharmacy-related issues.
  • Provide support to the customer service team, pharmacy coordinators, pharmacists, and members in resolving pharmacy claims, pricing, and coding issues.
  • Collaborate with internal stakeholders to resolve pharmacy-related gaps in care, coverage, and claims submission issues.
Requirements:
  • Must have valid Certified Pharmacy Technician - CPhT.
  • Bachelor's degree in Business or a related healthcare field, or 4 years of work experience in a pharmacy/healthcare/managed care industry.
  • Verbal and written communication skills.
  • Proficiency in MS product suite; Word, Excel, Access, and database software.
  • Drug information skills.
  • Handle multiple tasks and strong organizational skills.
  • Managed care customer service experience.
Preferred Requirements:
  • Retail/Hospital/Specialty Pharmacy, Pharmacy Benefits Manager, MCO, Health Plan pharmacy customer service experience.
  • Medicare/STARS, Facets knowledge or experience.
  • Inquisitive, continuous learning, critical thinking skills for understanding regulations, benefits, and ability to complete departmental projects.
  • Outbound telephone support to include members, providers, pharmacies, and PBM/vendor, program/campaign outreach.
  • Support through written and digital channels.


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