Pharmacy Service Specialist
Pharmacy Service Specialist
Green Key Resources
United States
See who Green Key Resources has hired for this role
Responsibilities
- Provides daily coordination of activities related to operations of pharmacy benefit management.
- Provides support to staff and coordinates tasks regarding the research, development, implementation and evaluation of programs, projects and initiatives.
- Serves as resource to staff and subject matter expert for assigned initiatives to provide input regarding pharmacy needs, impacts and projects.
- Resolves issues and escalates to management as appropriate; assists management in addressing clinical and contractual issues.
- Coordinates review, implementation, and quality assurance of benefit plan administration with internal stakeholders and PBM account team.
- Resolves or coordinates the resolution of escalated customer service inquiries and grievances internally and with PBM, including researching and authorizing/making pharmacy claim adjustments as appropriate.
- Coordinates the resolution of Pharmacy Coverage Determinations with Clinical Staff and/or external partners as appropriate
- Coordinates the resolution of pharmacy claim reconsiderations and appeals with the Appeals department and/or external partners as appropriate.
- Responsible for responding to and coordinating review and approval of RFPs, government program applications, and similar requests.
- High school diploma or GED
- 3+ years of experience in related field.
-
Seniority level
Mid-Senior level -
Employment type
Full-time -
Job function
Other -
Industries
Staffing and Recruiting
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