Pharmacy Operations Rep

Health Care Service; Chicago (IL); Hybrid; USD 41,000 - 73,000; Full time

Job summary

Health Care Service Corporation is seeking a claims and pricing support specialist for the pharmacy team, focusing on resolving medication claims and inquiries in collaboration with PBMs and internal departments.

The role includes inbound call handling, member/provider outreach, and data-driven efforts to improve operational outcomes within a hybrid in-office/remote schedule.

Qualifications

• Bachelor's degree in Business or related health care field or four years work experience in a health care/insurance
• Certified Pharmacy Technician
• Verbal and written communication skills
• Managed care customer service experience
• Proficiency with word processing, spreadsheets and database software
• Drug information skills
• Handle multiple tasks and strong organizational skills

Responsibilities

• Assist pharmacists and pharmacy coordinators in resolving medication claims and inquiries
• Collaborate with internal teams and external vendors to ensure timely and accurate issue resolution
• Manage inbound calls and conduct member and provider outreach
• Support population health initiatives and participate in data-driven operational projects

Skills

Verbal and written communication

Multitasking and organization

Drug information skills

Education

Bachelor's degree in Business or related health care field

Certified Pharmacy Technician

Tools

Word processing

Spreadsheets

Database software

Job description

Job Summary

This position is responsible for providing assistance to pharmacists and pharmacy coordinators in resolution of claims, pricing, coding. Works with internal departments and external vendors to evaluate and resolve pharmacy related issues.

Job Description

The position supports pharmacists and pharmacy coordinators in resolving medication claims and inquiries, working with internal teams and external vendors (e.g., PBMs) to ensure timely and accurate issue resolution. This role manages inbound calls, conducts member and provider outreach, and collaborates with pharmacists on account-based work to support medication management. Additionally, the position supports population health initiatives and participates in project-based, data-driven efforts to improve operational outcomes.

Job Requirements

• Bachelors degree in Business or a related health care field or four years work experience in a health care/insurance industry (or equivalent)
• Certified Pharmacy Technician
• Verbal and written communication skills
• Managed care customer service experience
• Demonstrated proficiency of word processing spreadsheets and database software
• Drug information skills
• Handle multiple tasks and strong organizational skills

This is a Flex (Hybrid) role: requires 3 days in office; 2 days remote

Pay Transparency Statement

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards .

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

Flex employees are expected to be in the office a minimum of three days a week. Management will have discretion to modify an employee's weekly schedule for exigent circumstances.

HCSC Employment Statement

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.

Base Pay Range

$40,500.00 - $72,500.00

Exact compensation may vary based on skills, experience, and location.