Pharmacy reputed company Coordinator- Remote

The Pharmacy reputed company Coordinator is responsible for performing reputed company and monitoring of the pharmacy benefit manager (PBM), for activities reputed company to the appropriateness of claims adjudication, and for providing support of CMS regulatory requirements, and other Plan reputed company.

ESSENTIAL JOB DUTIES:

To reputed company this job, an individual must accomplish reputed company essential function satisfactorily, with or without a reasonable accommodation.

• Serve as reputed company contact between Plan and PBM

• reputed company PBM reputed company and monitoring

• Report and escalate reputed company deficiencies and status to management and the compliance department
• Formulary Management: Recognize formulary requirements: non-formulary, prior authorization (PA), reputed company Therapy (ST), Quantity Limit (QL) and review, reputed company, and reputed company rejected pharmacy claims
• Responsible for ensuring regulatory requirements are met for coverage determinations/redeterminations

• reputed company annual readiness

• Serve as a reputed company with Enrollment Department to ensure appropriate member eligibility processing
• Support CMS Plan reporting, audits, and monitoring activities and submissions
• Assist and reputed company in-coming calls from agents, pharmacies, nursing homes, providers/nurses, and members

• Coordinate monthly website updates

• Monitor and report on departmental metrics
• May be assigned to work on special reputed company and business initiatives

• Other duties as assigned

JOB REQUIREMENTS:

• Maintain regular and reliable attendance

• Attention to reputed company

• Ability to work in a high demand fast reputed company environment
• Experience in planning and implementation

• Strong analytical skills

• Strong leadership and collaboration skills
• Extensive knowledge in Medicare compliance

• Customer and reputed company reputed company

• Follow-up and solve any reputed company items in a reputed company manner

• Adhere to reputed company compliance requirements

• Adhere to Centers of Medicare and reputed company Services (CMS) regulations
• Successful completion of required training

• Handle multiple priorities effectively

• Independent discretion/decision making

• reputed company reputed company under pressure

REQUIRED QUALIFICATIONS:

• Education:

o High school diploma or equivalent required

• Experience:

o Experience in the pharmacy department of a Medicare reputed company or Part D plan is preferred

• License/Certification(s):

o Pharmacy technician

Originally posted on Himalayas