Clinical - Pharmacy Coordinator 1 - 210120

Pacer Group; California (MO); Remote; USD 25,000 - 39,000; Full time

Job summary

Pacer Group is seeking a Pharmacy Coordinator 1 to support the pharmacy department in developing, coordinating, and maintaining the program. This remote role spans 6 months with potential extension, and follows a Mon-Fri 8:00 AM–4:00 PM schedule, paid on a W2 basis.

Responsibilities include handling prior authorization calls, formulary review, cost/utilization analysis, and provider education. Requires a high school diploma and 3+ years of pharmacy experience in managed care; Arizona license and

Qualifications

• 3+ years of pharmacy experience in a managed care environment.
• Current state's Pharmacy Technician license or ability to obtain.
• PTCB certification or ability to obtain within 30 days of start.

Responsibilities

• Receive and respond to provider and pharmacy calls regarding prior authorization and formulary.
• Review pharmacy and override processes in compliance with guidelines.
• Track overrides, audit prior authorizations, analyze cost and utilization patterns.
• Resolve complaints and grievances related to the pharmacy network with the Pharmacy team.
• Educate providers on the health plan's pharmacy process.
• Assist with pharmacy utilization review and reporting.
• Collaborate with Quality Improvement for meeting prep and minutes.
• Assist with members' formulary inquiries.
• Performs other duties as assigned.
• Complies with all policies and standards.

Skills

Pharmacy technician experience

Microsoft Office

Communication skills

Education

High school diploma

Tools

PTCB

Job description

Job Title: Pharmacy Coordinator 1

Location: Remote
Duration: 6 Months (Possibility to extend or convert)
Schedule: Monday Friday, 8:00 AM 4:00 PM
XXXX: XXXXXXXXXXX/hour on w2.

Interview Format:

• Microsoft Teams Interview
• Camera On Require

Position Purpose:

Perform duties to support the efforts pharmacy department in the development, coordination and maintenance of the pharmacy program.

For Health Plan:

High school diploma or equivalent. 3+ years of pharmacy experience, preferably in a managed care environment. Medicare and/or Medicaid experience preferred. Previous experience in call center or fast paced pharmacy answering multi-line phone system preferred.

License/Certificate: Current state's Pharmacy Technician license and Pharmacy Technician Certification Board (PTCB) or the ability to obtain both license and PTCB within 30 days of the start date.

For Arizona Complete Health:

License/Certificate: Current Arizona Pharmacy Technician license.

For Company's Pharmacy Services:

Prior experience using analysis tools or systems (ex: web based, custom, proprietary, etc.). Experience in the implementation of quality process improvement efforts. Experience documenting requirements, creating training materials and working directly with end users.

License/Certificate: Current state's Pharmacy Technician license preferred.

Responsibilities:

• Receive and respond to provider and pharmacy calls regarding the prior authorization and formulary process.
• Perform review of pharmacy and override process in compliance with pharmaceutical related company and State guidelines.
• Track and trend override to ensure criteria have been met, audit for prior authorizations, analyze cost and determine utilization patterns.
• Resolve complaints and grievances related to the pharmacy network in conjunction with the Pharmacy team.
• Assist Provider Relations and various departments with educating providers on the health plan's pharmacy process.
• Assist with the pharmacy utilization review and reporting process.
• Collaborate with Quality Improvement department with various meeting preparation and transcription of minutes.
• Assist with members' inquiries related to the formulary process.
• Performs other duties as assigned.
• Complies with all policies and standards

Education/Experience:

• High school diploma or equivalent. 3+ years of pharmacy experience, preferably in a managed care environment. Medicare and/or Medicaid experience preferred

Licensure:

• Preferred- prefer a Pharmacy Technician License but not required.

Top 3 must-have hard skills stack-ranked by importance:

1. Pharmacy Technician experience (open to PBM, retail, or other various experience)
2. Microsoft Office Experience Excel, Word, Outlook, Visio
3. Ability to work independent and keep good communication with about their project/assignment updates.

Additional qualities to look for:

Ability to multitask or properly prioritize work, Experience with projects or assignments that require attention to details