Pharmacy Benefits Coordinator: Care & Plan Liaison

Maryland Care Management, Inc; Poland; Remote; PLN 157,000 - 232,000; Full time

Benefits offered by this job

Medical, dental, and vision plans

100% employer term life insurance

Short and long-term disability

401k employer match

20 days PTO

Tuition assistance

Job summary

Maryland Care Management, Inc. (MCMI) is hiring a Pharmacy Benefit Coordinator to support clinical outreach for members, pharmacies, and providers, aiming to improve safety and outcomes and to advance HEDIS adherence initiatives.

The role includes administrative tasks for the Pharmacy Management team, reviewing PBM changes, and coordinating with utilization review, quality improvement, and population health teams. A Maryland Pharmacy Technician license and 2+ years of experience are preferred.

Qualifications

• Must have High School diploma or GED.
• Active Maryland Pharmacy Technician license with PTCB certification.
• Minimum two years of experience as a pharmacy technician.
• Experience in managed care/PBM environment preferred.
• Experience supporting utilization management/prior authorization processes.

Responsibilities

• Support HEDIS adherence projects with quality management.
• Assist in accurate implementation and coding of pharmacy benefits and formulary changes.
• Review pharmacy services recommended for denial and investigate data from plan providers.
• Assist in member management by collecting information from plan providers and data systems.
• Support pharmacy utilization review/quality improvement initiatives and provider relations.

Skills

PBM knowledge

Regulatory awareness

Written communication

Attention to detail

Problem solving

Education

Maryland Pharmacy Technician license

PTCB certification

Job description

Maryland Care Management, Inc. (MCMI) is hiring a Pharmacy Benefit Coordinator to support clinical outreach for members, pharmacies, and providers, aiming to improve safety and outcomes and to advance HEDIS adherence initiatives.

The role includes administrative tasks for the Pharmacy Management team, reviewing PBM changes, and coordinating with utilization review, quality improvement, and population health teams. A Maryland Pharmacy Technician license and 2+ years of experience are preferred.