Pharmacy Benefits Specialist - Contingent - Pharmacy Advantage

Henry Ford Health System; Detroit (MI); On-site; USD 40,000 - 60,000; Full time

Job summary

Join Henry Ford Health as a Pharmacy Benefits Specialist, where you will impact patient care by resolving pharmacy benefit coverage issues. This role involves handling claims and inquiries, ensuring patient access to medications, and collaborating with healthcare providers. With flexible scheduling and opportunities for professional growth, this position is essential in delivering exceptional patient services.

Benefits

Competitive health plan options

Tuition assistance

Discounts to various businesses

Qualifications

• High school diploma or higher required, with preferred Associates degree.
• Must hold a State of Michigan Pharmacy Technician License.
• Minimum two years of pharmacy technician experience required.

Responsibilities

• Handles drug claim adjudication issues and prescription prior authorization.
• Performs benefits investigation and resolves pharmacy-related inquiries.
• Coordinates patient treatment plans with medical staff.

Skills

Customer Service

Pharmacy Benefit Knowledge

Communication

Patient Advocacy

Education

High school diploma or G.E.D.

Associates degree (preferred)

State of Michigan Pharmacy Technician License

Job description

Exciting opportunity to join Henry Ford Health as a Pharmacy Benefits Specialist. Make an impact on patient care and contribute to Pharmacy Advantage success.

GENERAL SUMMARY:

Schedule: Contingent, candidate must have a flexible availability, available tentatively 2-3 times a week.

The Pharmacy Benefits Specialist is responsible for handling drug claim adjudication issues, prescription prior authorization, and pharmacy benefit inquiries from members/patients, physicians, pharmacies, and other internal and external individuals.
Is a subject matter expert in the resolution of pharmacy benefit coverage issues andcoordinating prior authorization and exception processes.

PRINCIPLE DUTIES AND RESPONSIBILITIES:

• Performs benefits investigation, prescription prior authorization, and researchesfinancial assistance needed to ensure patients have access to medications needed.
• Interprets patient treatment plans and medical notes for purposes of facilitating patientcare.
• Evaluates any pharmacy related inquiries (i.e., financial barriers, therapy managementrelated outcomes, non-adherence to therapy) and communicates with nursing,providers, social workers and physician staff any additional requirements or potentialbarriers to the treatment plan.
• Performs all necessary steps during order entry to ensure order gets to final verification.Ensures the process is completed quickly, accurately, and in accordance with patient’sneeds while maintaining the highest customer service/quality of care.
• Performs online ordering of prescriptions submitted to pharmacies.

This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and duties. It should be understood, therefore, that employees may be asked to perform job-related duties beyond those explicitly described above.

EDUCATION/EXPERIENCE REQUIRED:

• Requires a High school diploma or G.E.D. Associates degree preferred
• Requires State of Michigan Pharmacy Technician License.
• Requires a minimum of two years of previous pharmacy technician experience.
• Previous experience as a specialty pharmacy technician preferred.

This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.

Overview

Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services – from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford’s care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation’s most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. Learn more at henryford.com/careers .

The health and overall well-being of our team members is our priority. That’s why we offer support in the various components of our team’s well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. Our team members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees classified as contingent status are not eligible for benefits.

Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is

committed to the hiring, advancement and fair treatment of all individuals without regard to

race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,

weight, marital status, family status, gender identity, sexual orientation, and genetic information,

or any other protected status in accordance with applicable federal and state laws.

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