Senior Pharmacy Coordinator - Remote

Overview

The Senior Pharmacy Coordinator provides guidance to front line staff, ensuring effective delivery of Pharmacy call center services while addressing inquiries from providers and managing drug benefit requests.

In Short

• Guide staff in Pharmacy call center operations.
• Respond to inquiries from physicians and pharmacy providers.
• Monitor adherence to health plan regulations.
• Evaluate drug authorization requests and denials.
• Document all authorizations and denials accurately.
• Consult with clinical pharmacists as needed.
• Participate in member appeals and grievances.
• Ensure compliance with federal and state regulations.
• Maintain high efficiency and productivity.
• Perform other assigned duties.

Requirements

• High school diploma or GED required.
• Experience in pharmacy claims processing preferred.
• Pharmacy technician certification is a plus.
• Strong understanding of medications and formulary terminology.
• Excellent computer skills, especially in Microsoft Office.
• Strong interpersonal and communication skills.
• Organizational skills and attention to detail.
• Able to work in a fast-paced environment.
• Familiarity with Medicaid and Medicare regulations.
• Ability to work well with others.

Benefits

• Competitive salary based on experience.
• Opportunity to work remotely.
• Comprehensive health benefits.
• Supportive work environment.
• Career development opportunities.
• Flexible working hours.
• Employee assistance programs.
• Access to training and resources.
• Inclusive company culture.
• Retirement savings plan.