Pharmacy Intern Position

5 hours ago


Brooklyn, New York, United States MetroPlus Health Plan Full time
Job Summary

MetroPlusHealth is seeking a highly skilled Pharmacy Intern to join our team. As a Pharmacy Intern, you will be responsible for auditing and validating internal and external reports to ensure proper benefit configuration across all lines of business.

Key Responsibilities
  • Review daily claims reports to identify and report on the accuracy of the pharmacy benefit configuration.
  • Validate improper coding through verification between POS and UM platform systems.
  • Coordinate care between members, pharmacies, and providers to improve patient adherence for chronic medications.
  • Assist in preparing documentation for internal and external audits and regulatory submissions.
  • Reconcile benefit inconsistencies with members, pharmacies, and prescribers.
Requirements
  • High school diploma/GED, required.
  • Two years' experience as a Pharmacy Technician, preferred.
  • Pharmacy experience in a managed care environment preferred.
  • Experience in auditing preferred.
  • Experience in government programs (Medicare, Medicare Part D, and Medicaid) preferred.
Professional Competencies
  • Integrity and Trust
  • Customer Focus
  • Functional/Technical Skills

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