Pharmacy Coordinator

This is a fully remote position, open to applicants in United States.

📋 Description

• Assist the pharmacy department in the creation, coordination, and upkeep of the health plan's pharmacy program.

• Engage in outreach to providers and pharmacies through phone calls, letters, faxes, and reporting.

• Analyze pharmacy claims to detect trends and opportunities for enhancing compliance and medication adherence.

• Support initiatives related to quality improvement.

• Receive and address calls from providers and pharmacies concerning the prior authorization and formulary processes.

• Review pharmacy and override procedures to ensure compliance with company and state pharmaceutical guidelines.

• Monitor and analyze overrides, audit prior authorizations, assess costs, and evaluate utilization patterns.

• Address complaints and grievances related to the pharmacy network in collaboration with the Pharmacy team.

• Assist Provider Relations and other departments in educating providers on the health plan's pharmacy procedures.

• Aid in pharmacy utilization review and reporting.

• Work with Quality Improvement on meeting preparations and the transcription of minutes.

• Help members with questions regarding the formulary process.

• Perform additional duties as assigned.

• Adhere to all policies and standards.

⛳️ Requirements

• High school diploma or equivalent qualification.

• Over 3 years of experience in pharmacy.

• Previous experience in PBM, health plans, and/or managed care is highly desirable.

• Experience with Medicare and/or Medicaid is preferred.

• Familiarity with analysis tools or systems is necessary.

• Experience in implementing quality process improvement initiatives.

• Proficient in documenting requirements, creating training materials, and collaborating directly with end users.

• Excellent communication skills.

• Highly organized and detail-oriented.

• Comfortable navigating various software systems.

• Capable of prioritizing and successfully completing multiple tasks.

• Current Pharmacy Technician license in the state of Indiana is preferred.

• Availability to support Eastern Time business hours, Monday through Friday from 8:30 AM to 5:00 PM.

• Updated resume that aligns with education and experience requirements.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K retirement plan.

• Stock purchase options.

• Tuition reimbursement program.

• Paid time off in addition to holidays.

• Flexible work arrangements including remote, hybrid, field, or office schedules.

• Additional forms of incentives may be included in the total compensation package.