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Pharmacy Specialist
2 weeks ago
Medical Services - Remote in North Dakota - Pharmacy Specialist
As our Pharmacy Specialist, you will serve as the primary contact for Medicaid providers and members when it comes to pharmacy claims processing. You will play a vital role in ensuring that patients receive their medications on time by troubleshooting pharmacy claims issues in real time and providing clear information about department drug use review policies. This is a front-facing position where you will be the go-to person when claims challenges arise, helping make the process smoother for both pharmacies and patients.
You will work with pharmacies across North Dakota to make sure claims and reimbursements for pharmacy services are processed through the ND Medicaid pharmacy claim payment system correctly. You will also support and collaborate with pharmacies that may experience difficulties processing claims due to point-of-sale rejections and help them resolve issues quickly. When needed, you will enter authorizations for medications, update pharmacies on claim and prior authorization statuses, coordinate with other departments, and prepare reports for both internal and external stakeholders.
To succeed in this role, strong verbal and written communication skills are key, as you will interact with a variety of stakeholders. You will need to simplify complex issues to get to the root of the problem, use a systematic approach when tackling multiple tasks, and follow established protocols to ensure consistency and accuracy. You should be someone who stays calm under pressure and can defuse situations when working with individuals who may be frustrated. You should also be comfortable working with computers, navigating pharmacy software, and troubleshooting technical issues as they arise.
If you enjoy problem-solving, helping others, and making a real difference in ensuring North Dakotans receive timely access to their medications, this is the perfect opportunity for you.
To be considered for this position, you are required to have successfully completed some college coursework or be a licensed pharmacy technician. You must also have at least 4 years of work experience submitting or processing pharmacy or medical claims.
About HHS: ND HHS strives to make North Dakota the healthiest state in the nation by reinforcing the foundations of well-being: physical, economic, and behavioral. Those services are to be delivered as close to home as possible with a focus on dignity and respect. The keys to delivery of those services are the 2800 committed, compassionate ND HHS team members and more than $6 billion in funding from nearly 200 different federal, state, and special sources.
Location: ND HHS utilizes a blended workplace model. This position is Remote in North Dakota and bordering communities.
About Team ND
"Far and away the best prize life offers is the chance to work hard at work worth doing." - Theodore Roosevelt
More than 7,500 talented, hard-working people across sixty-three agencies have come together as Team North Dakota. At Team ND, we are driven to succeed through gratitude, humility, curiosity and courage. Our purpose is to empower people, improve lives, and inspire success. Join us in being legendary.
Total Rewards: The State of North Dakota is committed to providing team members with a strong and competitive rewards package that support you, your health and your family.
Considering a new position on Team ND? How does your current position stack up? Use our Total Rewards Calculator to estimate.
Application Procedures
Your resume should include information to demonstrate how you meet the minimum qualifications as posted. If the Department's Human Resource Division is unable to determine that you meet the minimum qualifications credit will not be given. All application material must be received on or before the closing date by 11:59 PM Central Standard Time (CST).
Applicants must be legally authorized to work in the United States. The Department of Health & Human Services does not offer or provide sponsorships.
This employer participates in E-Verify. Please visit the following website for additional information:
A copy of your qualifying degrees transcript and any applicable certifications or licensures must be provided at the time of an interview.
For more information about the position or if you need an accommodation, please contact LeNeika Roehrich at or at
Employing Unit: ND HHS - Medical Services
TTY Number: ND Relay Service text); voice)
If you are experiencing technical difficulties with the Application Process or uploading attachments, please contact or
Equal Employment Opportunity
The State of North Dakota and this hiring agency do not discriminate on the basis of race, color, national origin, sex (including sexual orientation and gender identity), genetics, religion, age or disability in employment or the provisions of services and complies with the provisions of the North Dakota Human Rights Act.
As an employer, the State of North Dakota prohibits smoking in all places of state employment in accordance with N.D.C.C. Sect
