Pharmacy Coordinator 1

Position Title: Pharmacy Coordinator 1

Work Location: Remote - Nationally sourced

Assignment Duration: 6 months

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

Position Summary:

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

Key Responsibilities:

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

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

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

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

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

* Assist with the pharmacy utilization review and reporting process

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

* Assist with members' inquiries related to the formulary process

* Performs other duties as assigned

* Complies with all policies and standards

Qualification & Experience:

* High school diploma or equivalent.

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

* Medicare and/or Medicaid experience preferred.

* Prior experience using analysis tools or systems (ex: web based, custom, proprietary, etc.).

* Experience in the implementation of quality process improvement efforts.

* Experience documenting requirements, creating training materials and working directly with end users.

* License/Certificate: Current state's Pharmacy Technician license preferred.