Pharmacy Benefits Coordinator I

Johns Hopkins Medicine; Northern (KY); Hybrid; USD 23,000 - 37,000; Full time

Job summary

Johns Hopkins Medicine is seeking a Pharmacy Benefits Coordinator to support coordination of pharmacy benefit programs and help members access medications. The role provides frontline assistance to members, providers, pharmacists, and internal staff on benefit inquiries, formulary coverage, and prior authorization processes.

Responsibilities include routine processing, documentation, and follow-up of prior authorizations in accordance with benefit plans and policies, with escalation for complex

Qualifications

• High School Diploma/GED or equivalent is required.
• Less than 2 years of experience in pharmacy benefits coordination is expected.

Responsibilities

• Coordinate pharmacy benefit programs to facilitate member access to medications.
• Provide frontline assistance to members, providers, pharmacists, and internal staff regarding inquiries, formulary coverage, and prior authorization processes.
• Process, document, and follow up on prior authorization requests in line with benefit plans and policies.
• Escalate complex cases and ensure compliance with health plan policies and regulatory standards.

Education

High School Diploma/GED or equivalent

Job description

Pharmacy Benefits Coordinator supports the coordination of pharmacy benefit programs to facilitate member access to medications. They provide frontline assistance to members, providers, pharmacists, and internal staff regarding pharmacy benefit inquiries, formulary coverage, and prior authorization processes. The incumbent performs routine processing, documentation, and follow-up of prior authorization requests in accordance with members’ benefit plans and established policies.

The Pharmacy Benefits Coordinator assists with researching and resolving basic pharmacy benefit and claims issues, escalating complex cases as appropriate. The incumbent communicates pharmacy benefit information, coverage guidelines, and formulary alternatives under supervision while ensuring compliance with health plan policies, payer requirements, and regulatory standards.

Requirements:

Education:

High School Diploma/GED or equivalent (Required)

Work Experience:

Less Than 2 Years of Experience in pharmacy benefits coordination

Salary Range:

Minimum 16.65/hour - Maximum 27.50/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.

The Hospital reserves the right to modify employee schedules as needed.

We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.