Hybrid Pharmacy Operations Specialist

E2E Alignment Healthcare USA, LLC; California (MO); Hybrid; USD 41,000 - 62,000; Full time

Benefits offered by this job

Hybrid work model

Job summary

Alignment Health in Orange, CA is seeking a Pharmacy Technician for a hybrid role that supports day-to-day operations of multiple Pharmacy Department programs and performs administrative tasks that do not require the Pharmacy Manager’s judgment.

Responsibilities include handling outbound calls to members, prescribers, and pharmacies, assisting with refills, drafting reports, and supporting CMS oversight with PBM processes.

Qualifications

• Requires Pharmacy Technician license.
• Preferred: Certified Pharmacy Technician.

Responsibilities

• Assist daily operations of Pharmacy Department programs and audits.
• Make high volume outbound calls to members, prescribers, and pharmacies regarding the Adherence program.
• Assist members with refills and contact prescriber offices for additional refills as needed.
• Draft routine reports and correspondence.
• Support CMS-required oversight processes with PBM and rebates, EOB reports, and transition reports.
• Respond to inquiries from physicians, members, and pharmacies about formulary and benefits.
• Coordinate with PBM for prior authorizations, overrides, and issue resolution.
• Ensure HIPAA confidentiality of member information.

Skills

Pharmacy terminology

Communication skills

Bilingual (EN/Spanish or EN/Chinese)

Problem solving

Education

HS Diploma or GED

Associate’s Degree in Pharmacy (preferred)

Job description

Alignment Health in Orange, CA is seeking a Pharmacy Technician for a hybrid role that supports day-to-day operations of multiple Pharmacy Department programs and performs administrative tasks that do not require the Pharmacy Manager’s judgment.

Responsibilities include handling outbound calls to members, prescribers, and pharmacies, assisting with refills, drafting reports, and supporting CMS oversight with PBM processes.