Pharmacy Support Coordinator

Pharmacy Support Coordinator - Population Health Management

Location (Hybrid): This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Work Hours: Monday - Friday, 8:00am - 5:00pm

The Pharmacy Support Coordinator (Pharmacy Technician II) is responsible for the interpretation and review of moderately complex prescriptions, population health management data, and troubleshooting adjudication issues including provider engagement work.

How you will make an impact:

• Verifies member information, clinical and cost of care data to identify pharmacists’ opportunities to improve health

• Educates providers on pharmacy-based rules related to prescriptions and medication resources or assistance programs

• Processes data requests from physicians' offices and ensures compliance with Medicare & Commercial requirements; informs relevant parties of quality and cost opportunities

• Conduct outreach to provider offices to close critical quality gaps in care.

• Provides resolution to grievances from provider groups

• Responds to inquiries from physicians, sales team, and internal partners related to formulary and prescription benefits

• Generates reports relating for physician utilization, Clinical Criteria, and other ad hoc reports

• Maintains record keeping of presentations and monthly reports

• Support the improvement of overall performance within provider organizations.

Minimum Requirements:

• Requires an active, professional license, if required by state law, State Pharmacy Technician Certification or National Certification based on applicable state(s) requirements, to practice as a Pharmacy Technician within the scope of practice in a state or territory of the United States.

• Requires H.S. diploma or equivalent and minimum of 2 years of pharmacy experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Experience with PBMs and Health plans preferred.

For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.