Pharmacy Coordinator 1

Position Title: Pharmacy Coordinator 1

Work Location: Remote - Nationally sourced (PST candidate preferred)

Assignment Duration: 6 months (with Possibility to extend or convert)

Work Schedule: Monday-Friday (8 AM to 4:30 PM). No overtime, and we can be flexible on the start/end time.

Work Arrangement: Remote - Nationally sourced

Position Summary:

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  Perform duties to support the efforts pharmacy department in the development, coordination, and maintenance of the health plan's pharmacy program.

  
  

Key Responsibilities:

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  Receive and respond to provider and pharmacy calls regarding the prior authorization and formulary process

  
  
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  Perform review of pharmacy and override process in compliance with pharmaceutical related company and State guidelines

  
  
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  Track and trend overrides to ensure criteria have been met, audit for prior authorizations, analyze cost and determine utilization patterns

  
  
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  Resolve complaints and grievances related to the pharmacy network in conjunction with the Pharmacy team

  
  
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  Assist Provider Relations and various departments with educating providers on the health plan's pharmacy process

  
  
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  Assist with the pharmacy utilization review and reporting process

  
  
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  Collaborate with Quality Improvement department with various meeting preparation and transcription of minutes

  
  
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  Assist with members' inquiries related to the formulary process

  
  
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  Performs other duties as assigned

  
  
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  Complies with all policies and standards

  
  

Qualification & Experience:

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  High school diploma or equivalent

  
  
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  3+ years of pharmacy experience, preferably in a managed care environment

  
  
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  Medicare and/or Medicaid experience preferred

  
  
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  Microsoft Office Experience - Excel, Word, Outlook, Visio

  
  
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  Pharmacy Technician license preferred, not required