Medicaid/Medicare Pharmacy Authorization Specialist

Dr. Mylissa's Medical Boutique; Northern (KY); Hybrid; USD 38,000 - 73,000; Full time

Benefits offered by this job

Medical, dental, vision

Bonus eligibility

Paid time off

Job summary

CVS Health is hiring a full-time Pharmacy Services Coordinator to support Medicaid/Medicare pharmacy coordination, handling intake and processing of requests, and ensuring compliance with clinical guidelines.

You will evaluate requests, communicate decisions to physicians and pharmacies, and maintain documentation to meet regulatory and accreditation standards. The role emphasizes accuracy, confidentiality, and teamwork.

Qualifications

• National Pharmacy Technician certification and valid Home State license in good standing.
• Proficiency with computerized pharmacy systems and software applications.
• Excellent verbal and written communication skills.
• Experience with Windows-based software applications.
• Protects confidentiality of member information and follows policy.

Responsibilities

• Coordinate Medicaid and/or Medicare pharmacy services intake and processing.
• Evaluate and authorize pharmacy requests per clinical guidelines.
• Communicate decisions to physicians, staff, members, and pharmacies.
• Maintain documentation meeting risk, regulatory, and accreditation standards.
• Conduct clinical and non-medical research to support requests.

Skills

Pharmacy software

Excellent communication

Attention to detail

Data entry

Education

High School diploma or GED

Tools

Pharmacy systems

Job description

CVS Health is hiring a full-time Pharmacy Services Coordinator to support Medicaid/Medicare pharmacy coordination, handling intake and processing of requests, and ensuring compliance with clinical guidelines.

You will evaluate requests, communicate decisions to physicians and pharmacies, and maintain documentation to meet regulatory and accreditation standards. The role emphasizes accuracy, confidentiality, and teamwork.