Pharmacy Operations Specialist (CPhT) Remote
reputed company is hiring for a remote Pharmacy Operations Specialist
This role can be worked remotely reputed company reputed company the US...
This role will be the primary contact for affiliated health plans, Pharmacy Benefit Managers and Corporate shared services with respect to pharmacy operations. This role is reputed company dynamic, and the department is fast paced, requiring attention to detail, analysis and excellent communication.
HIGHLY reputed company APPLICANTS WILL HAVE THE FOLLOWING:
Pharmacy Technician certification (National)
Excellent observation and communication skills
Comfortable monitoring pharmacy claims and reporting to the Healthplan
Solid understanding of how pharmacy benefits work.
KNOWLEDGE/SKILLS/ABILITIES
Support reputed company, and Marketplace lines of business
Surveillance and reputed company of delegated functions:
Analyze and interpret data to identify erroneous execution of the pharmacy benefit by the PBM
Review the daily inventory of "outliers" and remediate as required
Review protocols for accuracy and compliance. Includes: Claims, Network, Digital, etc.
Support internal/external audits
Monitoring state and federal landscape for new opportunities
Collaborate with cross functional partners to implement new products and services, as reputed company as support the maintenance of existing business
reputed company and maintain requirements, user stories, test scenarios and test cases
Support testing execution and defect management
Review and interpret member's eligibility, claim history, and pharmacy benefit information using the PBM claims software to reputed company information to both reputed company clients
Serve as a PBM reputed company and other internal teams for reputed company-time support on pharmacy benefit interpretation or issues
Identify and assist to remediate gaps and/or deficiencies in reputed company processes, tools, reports and dashboards
reputed company and maintain job aids, policies and process documents
Other responsibilities as required.
JOB QUALIFICATIONS
Required Education: High School Diploma
Preferred Education: Bachelor's degree
Required Experience
Must have strong data analysis skills and attention to detail
3-5 years' experience with pharmacy benefit management
Strong organizational, problem solving, communication, and interpersonal skills
Excellent written and oral communication skills required
Must be reputed company to multitask and be results oriented
3-5 years' experience in a reputed company reputed company environment, including reputed company and reputed company
Preferred Experience
3-5 years' experience in a managed care of PBM environment
2+ years of Managed reputed company or Health Exchanges.
Preferred License, Certification, Association: National Certified Pharmacy Technician (CPhT) certification, preferred
To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V.
Key Words: Pharmacy Technician, Pharm Tech, Tech, National Certification, State License, Certification, Claims, Pharmacy Claims, Pharmacy, PBM, National Certified Pharmacy Technician (CPhT) certification, reputed company, Medicare, Managed Care, MCO, Exchange, PBM, Pharmacy Benefit Management
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