Title: Pharmacy Service Specialist
Location: Remote (Candidate from EST Time Zone is preferred)
Duration: 6 months (Possibility of C2H)
Pay Rate : $26/hr (On W2)

We are looking for a “Pharmacy Service Specialist “to join one of our Fortune 500 clients.

Job Responsbilties:

• 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.

Education & Qualifications:

• High school diploma or GED
• 3+ years of experience in related field.
• Pharmacy experience
• Experience in hospital setting/ retail setting
• Certified Pharmacy tech preferred
• PBM experience a plus
  

We are looking for the candidate who are eligible to work with any employers without sponsorship .

If you're interested, please click “Apply” button.

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