Pharmacy Operations Representative – Work From Home

HCSC; Helena (MT); Remote; USD 41,000 - 73,000; Full time

Benefits offered by this job

Remote work

Job summary

Health Care Service Corporation (HCSC) is seeking a licensed Pharmacy Technician to support pharmacists and pharmacy coordinators in reviewing clinical documentation for medical necessity based on policy. The role involves collaboration with internal teams and external vendors to resolve prior authorization issues.

The position emphasizes customer service, drug information, and strong communication skills. This remote role may have specific hours and weekend rotations; sponsorship is not

Qualifications

• Current Licensed/Certified Pharmacy Technician.
• Managed care customer service experience.
• Drug information skills.
• Verbal and written communication skills.
• Proficiency in word processing, spreadsheets, and databases.
• Bachelor’s degree in Business or a related health care field or four years work experience in a health care/insurance industry.

Responsibilities

• Provide assistance to pharmacists and pharmacy coordinators in resolving medical necessity determinations.
• Review clinical documentation for medical policy adherence.
• Collaborate with internal departments and external vendors to resolve prior authorization issues.

Skills

Pharmacy tech license

Customer service

Drug information

Communication skills

Office skills

Multi-tasking

Education

Bachelor’s degree in Business or health care

Healthcare/insurance experience (4 years)

Job description

Remote

NM - Albuquerque

MT - Helena

OK - Tulsa

IL - Chicago

TX - Richardson

Full time

R0056019

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

This position is responsible for providing assistance to pharmacists and pharmacy coordinators in resolution to reviewing clinical documentation for medical necessity based on medical policy. Works with internal departments and external vendors to evaluate and resolve medical prior authorization related issues.

JOB REQUIREMENTS:

• Current Licensed/Certified Pharmacy Technician
• Managed care customer service experience
• Drug information skills
• Verbal and written communication skills
• Demonstrated proficiency in word processing, spreadsheets, and database
• Skills to handle multiple tasks and organizational skills
• Bachelor’s degree in Business or a related health care field or four years work experience in a health care/insurance industry.

PREFERRED JOB REQUIREMENTS:

• Retail Pharmacy experience
• Must be a Current Licensed/Certified Pharmacy Technician
• Work Hours are Thursday through Monday (8 hours between 7AM - 6 PM MST) OR Monday through Friday (8 hours between 7AM - 6 PM MST) with Weekend Rotations
• Training Hours are Monday through Friday 7AM - 3 PM MST

#LI-FW1

#LI-Remote

This is a Remote/Work-From-Home role.

Sponsorship is not available

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.

This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii .

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.

For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities.

Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment.

HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants.

If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations.

Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions.

Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas,

Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association

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