Pharmacy Support Coordinator

Elevance Health; Mason (OH); Hybrid; USD 42,000 - 54,000; Full time

Benefits offered by this job

Paid holidays

Paid Time Off

Medical benefits

Dental benefits

Vision benefits

401(k) + match

Stock purchase plan

Job summary

Elevance Health is seeking a Pharmacy Support Coordinator (Pharmacy Technician II) in a hybrid role. The job involves interpreting and reviewing moderately complex prescriptions, population health data, and resolving adjudication issues with provider engagement.

The position requires an active pharmacy technician license (if required by state law) and a minimum of 2 years of pharmacy experience. Hybrid in-office 1–2 days per week with potential alternates based on location, plus vaccination

Qualifications

• Active professional license as Pharmacy Technician if state law requires.
• HS diploma or equivalent with a minimum of 2 years of pharmacy experience or equivalent education/experience.
• Experience with PBMs and health plans preferred.

Responsibilities

• Verifies member information, clinical and cost of care data to identify opportunities to improve health.
• Educates providers on pharmacy-based rules related to prescriptions and medication resources or assistance programs.
• Processes data requests from physicians' offices and ensures compliance with Medicare & Commercial requirements; informs relevant parties of quality and cost opportunities.
• Conduct outreach to provider offices to close critical quality gaps in care.
• Provides resolution to grievances from provider groups.
• Responds to inquiries from physicians, sales team, and internal partners related to formulary and prescription benefits.
• Generates reports relating to physician utilization, Clinical Criteria, and other ad hoc reports.
• Maintains record keeping of presentations and monthly reports.
• Support the improvement of overall performance within provider organizations.

Skills

Pharmacy Technician

PBMs experience

Education

HS diploma or equivalent

Job description

Pharmacy Support Coordinator - Population Health Management

Location (Hybrid): This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Work Hours: Monday - Friday, 8:00am - 5:00pm

The Pharmacy Support Coordinator (Pharmacy Technician II) is responsible for the interpretation and review of moderately complex prescriptions, population health management data, and troubleshooting adjudication issues including provider engagement work.

How you will make an impact:

• Verifies member information, clinical and cost of care data to identify pharmacists’ opportunities to improve health
• Educates providers on pharmacy-based rules related to prescriptions and medication resources or assistance programs
• Processes data requests from physicians' offices and ensures compliance with Medicare & Commercial requirements; informs relevant parties of quality and cost opportunities
• Conduct outreach to provider offices to close critical quality gaps in care.
• Provides resolution to grievances from provider groups
• Responds to inquiries from physicians, sales team, and internal partners related to formulary and prescription benefits
• Generates reports relating for physician utilization, Clinical Criteria, and other ad hoc reports
• Maintains record keeping of presentations and monthly reports
• Support the improvement of overall performance within provider organizations.

Minimum Requirements:

• Requires an active, professional license, if required by state law, State Pharmacy Technician Certification or National Certification based on applicable state(s) requirements, to practice as a Pharmacy Technician within the scope of practice in a state or territory of the United States.
• Requires H.S. diploma or equivalent and minimum of 2 years of pharmacy experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

• Experience with PBMs and Health plans preferred.

For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the Accessibility Accommodation Request Form and a member of the team will be in contact.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.