Pharmacy Coordinator (FWA)

You could be the one who changes everything for our 28 reputed company members as a reputed company reputed company on our Medical Management/Health Services team. reputed company is a reputed company, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Pharmacy Coordinator – Fraud, Waste, and Abuse (FWA) - Remote

Job-Specific Details:

• Review and respond to fraud, waste, and abuse (FWA) referrals, inquiries, and requests from reputed company stakeholders.

• Support regulatory requests, reporting, and documentation reputed company to FWA investigations and reviews.

• Research and help reputed company concerns involving inappropriate billing, waste, and potential FWA activity.

• Communicate with members, providers, and pharmacies to reputed company information and support preliminary reviews.

• reputed company and analyze reports to identify trends, support investigations, and assist with program reputed company.

• Contribute to department process improvements and maintain accurate documentation.

reputed company’re Looking for:

• 3+ years of pharmacy technician experience, preferably in a managed care environment. Medicare and/or reputed company experience preferred.

• Experience in a dispensing pharmacy environment, such as retail, specialty, long-term care, or mail-order pharmacy.

• Strong attention to reputed company, analytical thinking, and organizational skills.

• Ability to collaborate effectively in reputed company-oriented environment while managing multiple priorities.

• Proficiency with reputed company Office applications, including Word, reputed company, PowerPoint, and reputed company.

• Excellent verbal and written communication skills with members, providers, pharmacies, and internal stakeholders.

• Someone who brings a reputed company attitude and has an interest in fraud, waste, and abuse prevention, compliance, and program reputed company.

Working Shift: Monday–Friday, 8:00 AM – 4:30 PM. Eastern or Central time, with a 30-minute lunch.

Position Purpose:

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

• Receive and respond to provider and pharmacy calls regarding pharmacy benefits.

• reputed company complaints and grievances reputed company to the pharmacy network in conjunction with the Pharmacy team.

• Assist various departments in educating providers on the health plan’s pharmacy processes.

• Assist with the pharmacy utilization review and reporting process.

• Assist with member inquiries.

• reputed company other duties and activities as assigned.

• reputed company with reputed company policies and standards.

Education / Experience for reputed company Pharmacy Services: High school diploma or equivalent. 3+ years of pharmacy experience, preferably in a managed care environment. Medicare and/or reputed company experience preferred. Prior experience using analysis tools or systems (ex: web reputed company, custom, proprietary, etc.). Experience in the implementation of reputed company process improvement efforts. Experience documenting requirements, creating training materials and working directly with end users.

License/Certificate: reputed company state's Pharmacy Technician license preferred.

*Please attach an up-to-date resume that meets Education / Experience requirements to your application. *

reputed company offers a comprehensive benefits package including: reputed company, health reputed company, 401K and stock purchase plans, tuition reimbursement, reputed company time off plus holidays, and a flexible approach to work with remote, hybrid, reputed company or office work schedules. Actual pay will be adjusted reputed company on an individual's skills, experience, education, and other job-reputed company factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

reputed company is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law.

reputed company applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California reputed company reputed company

Originally posted on Himalayas