PBM Pharmacy Technician

OptiMed Health Partners; Kalamazoo (MI); On-site; USD 10,000 - 60,000; Full time

Job summary

A leading health company in Kalamazoo is seeking a Helpdesk Technician to support pharmacies and enhance member experiences. The role involves resolving incoming inquiries, assisting with pharmacy benefit details, and collaborating with various professionals. Ideal candidates will have prior pharmacy experience and strong communication skills to thrive in this entry-level position.

Benefits

Medical insurance

Vision insurance

401(k)

Qualifications

• 1-2 years of experience in pharmacy or related field required.
• Significant knowledge of the pharmacy industry is necessary.
• Must communicate effectively and be reliable.

Responsibilities

• Assist members with pharmacy benefit plan design details.
• Coordinate prior authorizations for all stakeholders.
• Troubleshoot claims processing issues for pharmacies.

Skills

Communication

Problem Solving

Attention to Detail

Organization

Job description

2 days ago Be among the first 25 applicants

OptiMed Health Partners provided pay range

This range is provided by OptiMed Health Partners. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.

Base pay range

$19.00/hr - $20.00/hr

Direct message the job poster from OptiMed Health Partners

The Helpdesk Technician (HDT) is responsible for supporting pharmacies, members, brokers, third-party administrators (TPA’s) and other health professionals regarding pharmacy benefit claim adjudications.

The HDT is a key point of contact to all individuals reaching out to OptiMed. The HDT is responsible for coordinating and facilitating member care services and communications that help to enhance the member’s experience. The HDT will collaborate with the member, pharmacies, medical providers, TPA’s to ensure prescription claims process properly according to the member’s plan sponsor’s benefit design. The HDT position is very broad in terms of different professionals they will interact and support including: broker’s, TPA’s, Human Resource Representatives (HR), Pharmaceutical Manufacturers, and OptiMed’s clinical and account management teams.

Primary responsibilities are:

• Incoming call resolution from members, brokers, HR, TPA’s, etc.
• Assist members with understanding their pharmacy benefit plan design details: (copay’s, formulary, formulary alternatives, deductibles, etc.).
• Liaison between Ascend and pharmacy partners in assisting for the following:
• - Member Setup in Pharmacy Software
• - Unbranded prior auth processing
• - Adding to the patient’s med list within pharmacy software
• - Communicating with pharmacies to assist in billing platforms.
• - Onboarding new patients.
• - Eligibility needs.
• - Troubleshoot claims processing issues for pharmacies.

Additional responsibilities include:

• Coordinate, setup, and communicate prior authorization (PA) for all stakeholders: members, pharmacies, and providers.
• Work with OptiMed Health Partners’ various teams to ensure a cohesive member experience.
• Additional tasks as may be assigned by the Operations Supervisor.

Supervisory Responsibilities

The HDT does not hold a supervisory role. The HDT reports directly reports to the PBM Operations Supervisor.

Minimum Qualifications

A minimum of 1-2 years of experience in pharmacy is required. Must be familiar with standard pharmacy protocol, insurance practices, and patient assistance programs. While a license in pharmacy is not required, significant knowledge of the pharmacy industry is required. The HDT must be able to work efficiently in a structured environment, follow directions, communicate effectively and be reliable. Attention to detail, organization and resourcefulness is key. The HDT must have strong communication skills, problem solving abilities, and an independent self-starter attitude.

The HDT thrives in a fast-paced work environment. Sitting for prolonged periods of time at a desk, spending large amounts of time working on a computer and/or talking on the telephone in an office setting. Light to moderate lifting may be required at times. Must be able to spend most of the day in an open, work environment with other HDT’s, pharmacy technicians and staff members alike. Reasonable accommodations can be made to enable individuals with disabilities to perform the essential job functions. The position is based at our Headquarters location here in Kalamazoo, MI.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care and Insurance

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Inferred from the description for this job

Medical insurance

Vision insurance

401(k)

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