JOB REQUIREMENTS: Pharmacy Specialist Job Locations US-WI ID 2024-2061
Category Clinical Services Type Regular Full-Time Overview Do you have a
passion for providing exceptional customer experience? Do you have an
interest in improving the health of others by collaborating with team
members to solve problems that support the needs of our customers? If
so, please consider applying for our Pharmacy Specialist position!
Quartz is looking for an organized, adaptable Pharmacy Technician to
work as a Pharmacy Specialist. This position will be responsible for
processing pharmacy related coverage decisions for all utilization
management requests in accordance with standards for accuracy,
timeliness, productivity, and regulatory requirements. Also, this
position with will be interacting with both internal and external
customers to provide and obtain information and ensures the delivery of
outstanding service and quality. Benefits: Typical work week; Monday -
Friday, 8 am - 5pm. May vary due to urgent business needs. Opportunities
for learning new skills and advancement Starting pay rate: \$20 /hr.
based on skills and experience + robust total rewards package.
Responsibilities Process and finalize all requests within turnaround
time (TAT) utilizing guidelines and other applicable regulatory
requirements Enter coverage requests into the system and prioritize as
required Check formulary alternatives, review tried and failed
medications Utilize drug references and verify the drug being requested
is indicated and approved for the condition Document all related
information regarding the coverage decision Respond to coverage requests
by faxing status to the physician Conforms to defined roles &
responsibilities and rules of engagement between coverage decisions
processing and clinical decision making Partners with assigned clinical
pharmacists to accurately and efficiently complete coverage decisions
Accountable to achieve productivity and accuracy standards Analyzes,
researches, and resolves coverage decision processing issues including
making written or telephone inquiries to obtain information from PBM,
members, physicians, or pharmacies. Qualifications High School Diploma
or equivalency is required; Bachelor\'s degree in a related field
preferred. 3+ years previous experience in a health care setting,
managed care, PBM, or pharmacy setting is required. Managed Health Care,
Pharmacy and Claims Billing, Medicare Part D or a related field
experience is preferred. Understanding of managed pharmacy benefit
concepts including formularies, prior authorizations, and claim
adjudication. Understand medical terminology and Medicare regulation.
Certified Pharmacy Technician (CPHT) or obtain CPHT within 12 months of
hire. Excellent oral and written communication... For full info follow
application link. Equal Opportunity Employer of Minorities, Females,
Protected Veterans, and Individual with Disabilities *****
APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/A3D2172815504CC1