Cadence, Customer Support/Service, Data Cleaning, Detail Oriented, Establish Priorities, Fax Machines, Formulary, Healthcare Effectiveness Data and Information Set (HEDIS), Identify Issues, Managed Care, Medications, Organizational Skills, Performance Metrics, Pharmacy, Problem Solving Skills, Quality Management, Quality Metrics, Time Management
Job Title: Pharmacy Coordinator
Location: Remote | IN preferred
Duration: 4 months (Possible Extensions)
Work Hours: M-F, 8:30am-5:00pm ET (flex as needed for outreach/operational needs). Occasional OT may be required during peak measure cycles.
PR: $20-23.00/HR
Position Summary
Support the Pharmacy team by driving pharmacy-related quality measure performance through targeted member/provider/pharmacy outreach, issue resolution (e.g., medication access/PAs), and tracking/reporting.
Key Responsibilities
Review assigned quality measure reports (weekly/monthly cadence varies by measure), identify members/providers/pharmacies with open gaps, and execute outreach (calls/letters/faxes) to members/guardians, provider offices, and pharmacies.
Document outcomes, troubleshoot medication access barriers (e.g., prior auth status, pharmacy processing issues), and escalate as needed.
Maintain measure trackers, summarize outreach results, and communicate updates to the pharmacy/quality team.
Qualifications:
Experience:
Years of experience required: 3+ years pharmacy technician/pharmacy operations experience (managed care and/or quality/outreach experience strongly preferred).
Disqualifiers: No active/eligible Pharmacy Technician license (Indiana); inability to work independently; poor communication/customer service skills; discomfort with outbound outreach to members/providers; inability to use Excel for report review/tracking; non-compliance with PHI/required documentation.
Additional qualities to look for: Highly organized self-starter; strong attention to detail; able to prioritize competing deadlines across multiple measures; confident communicating with provider offices/pharmacies and members/guardians; experience with HEDIS/Stars measures and medication adherence interventions; proactive problem-solver who can identify barriers and escalate appropriately.
Skills:
Advanced Excel/report skills (filtering/sorting, data cleanup) and ability to build/maintain trackers and summarize results.
Quality measure/HEDIS outreach workflow experience (interpreting measure gap lists, executing member/provider/pharmacy outreach, and documenting outcomes).