Pharmacy Benefits Specialist - Contingent - Pharmacy Advantage

Henry Ford Health; Rochester Hills (MI); On-site; USD 60,000 - 80,000; Full time

Job summary

Join Henry Ford Health as a Pharmacy Benefits Specialist in a contingent role, where you'll facilitate patient access to necessary medications. This role requires handling inquiries regarding pharmacy benefits and performing prior authorizations. Applicants should have previous experience as a pharmacy technician and possess a Michigan Pharmacy Technician License.

Qualifications

• Requires a minimum of two years of previous pharmacy technician experience.
• Previous experience as a specialty pharmacy technician preferred.

Responsibilities

• Handles drug claim adjudication issues and prescription prior authorization.
• Evaluates pharmacy-related inquiries and communicates with healthcare providers.
• Performs benefits investigation and manages patient access to medications.

Skills

Communication

Problem Solving

Customer Service

Data Entry

Education

High school diploma or G.E.D.

Associates degree preferred

State of Michigan Pharmacy Technician License

Job description

Join to apply for the Pharmacy Benefits Specialist - Contingent - Pharmacy Advantage role at Henry Ford Health

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Join to apply for the Pharmacy Benefits Specialist - Contingent - Pharmacy Advantage role at Henry Ford Health

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 and coordinating prior authorization and exception processes.

Principle Duties And Responsibilities

• Performs benefits investigation, prescription prior authorization, and researches financial assistance needed to ensure patients have access to medications needed.
• Interprets patient treatment plans and medical notes for purposes of facilitating patient care.
• Evaluates any pharmacy related inquiries (i.e., financial barriers, therapy management related outcomes, non-adherence to therapy) and communicates with nursing, providers, social workers and physician staff any additional requirements or potential barriers 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’s needs 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.
  
  

Additional Information

• Organization: Community Care Services
• Department: Pharmacy Advantage Rochester H
• Shift: Day Job
• Union Code: Not Applicable

Seniority level

• Seniority level

  Associate

Employment type

• Employment type

  Contract

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care, Insurance, and Wellness and Fitness Services

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