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Pharmacy Services Specialist
4 months ago
Title: Pharmacy Service Specialist
Location: Remote (Candidate from EST Time Zone is preferred)
Duration: 6 months (Possibility of C2H)
Pay Rate : $26/hr (On W2)
We are looking for a “Pharmacy Service Specialist “to join one of our Fortune 500 clients.
Job Responsbilties:
- Provides daily coordination of activities related to operations of pharmacy benefit management.
- Provides support to staff and coordinates tasks regarding the research, development, implementation and evaluation of programs, projects and initiatives.
- Serves as resource to staff and subject matter expert for assigned initiatives to provide input regarding pharmacy needs, impacts and projects.
- Resolves issues and escalates to management as appropriate; assists management in addressing clinical and contractual issues.
- Coordinates review, implementation, and quality assurance of benefit plan administration with internal stakeholders and PBM account team.
- Resolves or coordinates the resolution of escalated customer service inquiries and grievances internally and with PBM, including researching and authorizing/making pharmacy claim adjustments as appropriate.
- Coordinates the resolution of Pharmacy Coverage Determinations with Clinical Staff and/or external partners as appropriate
- Coordinates the resolution of pharmacy claim reconsiderations and appeals with the Appeals department and/or external partners as appropriate.
- Responsible for responding to and coordinating review and approval of RFPs, government program applications, and similar requests.
Education & Qualifications:
- High school diploma or GED
- 3+ years of experience in related field.
- Pharmacy experience
- Experience in hospital setting/ retail setting
- Certified Pharmacy tech preferred
- PBM experience a plus
We are looking for the candidate who are eligible to work with any employers without sponsorship.
If you’re interested, please click “Apply” button.
If you are not available or this job is not a good fit at present, please share the job details with your friends/colleagues and let me know if anyone is interested
