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Job Description
- Req#: J271139
Employer Industry: Healthcare Services
Why consider this job opportunity:
- Salary up to $23.72
- Opportunity for career advancement and growth within the organization
- Supportive and collaborative work environment
- Chance to make a positive impact on patient care and medication management
- Opportunity to work with a diverse team of healthcare professionals
What to Expect (Job Responsibilities):
- Communicate effectively with physician and pharmacy network providers to address their needs in a timely manner
- Review and prioritize drug authorization requests or denials
- Document all authorizations and denials accurately and in accordance with regulations
- Consult with clinical pharmacists for guidance on complex cases
- Participate in onsite member appeals and grievance sessions as a pharmacy representative
What is Required (Qualifications):
- High school diploma or GED
- Experience in pharmacy prescription claims processing/submission/payment
- Familiarity with Medicaid and Medicare drug benefit design offerings and regulations
- Strong organizational skills and attention to detail
- Excellent interpersonal and communication skills
How to Stand Out (Preferred Qualifications):
- Associate degree
- Pharmacy technician certification
- Experience working in a managed care medication formulary management environment
- Working knowledge of retail pharmacy and third-party prescription processing
- Strong background in medications and formulary terminology
#HealthcareServices #Pharmacy #CareerOpportunity #CompetitivePay #MedicationManagement
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