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Pharmacy Operations Rep

2 months ago

Richardson, United States Health Care Service Corporation Full time

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

As a valued member of our Pharmacy Operations team, you would be responsible for providing assistance to the customer service team, pharmacy coordinators, pharmacists and members in resolution of various pharmacy claims, pricing, coding issues. Working with internal departments and external vendors to evaluate and resolve pharmacy related issues.

This role will provide a flex schedule requiring 3 days working in the office, allows up to 2 days working from home. Core Business hours are 8:30am – 5pm, Monday - Friday.

JOB REQUIREMENTS:
* Certified Pharmacy Technician – current.
* Bachelor's degree in Business or a related health care field OR 4 years work experience in a pharmacy/health care/managed care industry.
* Verbal and written communication skills.
* Managed care customer service experience.
* Proficiency of MS product suite; Word, Excel, Access, and database software.
* Drug information skills.
* Handle multiple tasks and strong organizational skills.

PREFERRED JOB REQUIREMENTS:
* Retail, Hospital, Specialty Pharmacy, PBM, Health Plan experience.
* Telephone support to include members inquiries, providers, pharmacies, and groups regarding benefits.

* Support through written and digital channels.
* Effectively working across / collaborating with internal stakeholders, PBM / Pharmacy, Providers, members to resolve pharmacy related gaps in care, coverage & claims submission issues.
* Facilitate process for clinical & benefit overrides, Step Therapy and prior-authorization efforts in the PBM claims systems for Utilization Management (UM) and Clinical Services.

*Available during core business hours Monday – Friday 8:30 - 5pm
 

This is a flex role which requires 3 days working in the office and allows up to 2 days working from home per week. Office location(s): Richardson, TX or Chicago, IL or Downers Grove, IL or Helena, MT or Albuquerque, NM or Tulsa, OK


Relocation is not available at this time.
Sponsorship is not provided

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process

HCSC Employment Statement:

We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.