Hybrid Pharmacy Support Coordinator - Population Health

Elevance Health; Ohio; Hybrid; USD 42,000 - 64,000; Full time

Job summary

Elevance Health is seeking a Pharmacy Support Coordinator to interpret and review moderately complex prescriptions and population health data, while troubleshooting adjudication issues and engaging providers. This hybrid role blends in-office collaboration with virtual work to support patient care goals.

The position emphasizes ensuring compliance with Medicare and commercial requirements, provider outreach to close quality gaps, and generating utilization and clinical reports.

Qualifications

• Active professional license and pharmacy certification required where applicable.
• High school diploma or equivalent with 2 years of pharmacy experience.
• Excellent oral, written and interpersonal communication skills.

Responsibilities

• Verify member information and data to identify opportunities to improve health.
• Educate providers on pharmacy rules and medication resources or assistance programs.
• Process data requests and ensure Medicare and Commercial compliance.
• Conduct outreach to provider offices to close quality gaps in care.
• Respond to inquiries from physicians and internal teams about formulary and benefits.
• Generate reports on physician utilization and clinical criteria.
• Maintain records of presentations and monthly reports.
• Support overall performance improvement in provider organizations.

Skills

Pharmacy experience

PBMs experience

Analytical skills

Oral communication

Written communication

Interpersonal skills

Education

High school diploma or equivalent

State Pharmacy Technician Certification

Tools

PBMs systems

Job description

Elevance Health is seeking a Pharmacy Support Coordinator to interpret and review moderately complex prescriptions and population health data, while troubleshooting adjudication issues and engaging providers. This hybrid role blends in-office collaboration with virtual work to support patient care goals.

The position emphasizes ensuring compliance with Medicare and commercial requirements, provider outreach to close quality gaps, and generating utilization and clinical reports.