Remote Pharmacy Coordinator: PriorAuth & Analytics

Pacer Group; California (MO); Remote; USD 25,000 - 39,000; Full time

Job summary

Pacer Group is seeking a Pharmacy Coordinator 1 to support the pharmacy department in developing, coordinating, and maintaining the program. This remote role spans 6 months with potential extension, and follows a Mon-Fri 8:00 AM–4:00 PM schedule, paid on a W2 basis.

Responsibilities include handling prior authorization calls, formulary review, cost/utilization analysis, and provider education. Requires a high school diploma and 3+ years of pharmacy experience in managed care; Arizona license and

Qualifications

• 3+ years of pharmacy experience in a managed care environment.
• Current state's Pharmacy Technician license or ability to obtain.
• PTCB certification or ability to obtain within 30 days of start.

Responsibilities

• Receive and respond to provider and pharmacy calls regarding prior authorization and formulary.
• Review pharmacy and override processes in compliance with guidelines.
• Track overrides, audit prior authorizations, analyze cost and utilization patterns.
• Resolve complaints and grievances related to the pharmacy network with the Pharmacy team.
• Educate providers on the health plan's pharmacy process.
• Assist with pharmacy utilization review and reporting.
• Collaborate with Quality Improvement for meeting prep and minutes.
• Assist with members' formulary inquiries.
• Performs other duties as assigned.
• Complies with all policies and standards.

Skills

Pharmacy technician experience

Microsoft Office

Communication skills

Education

High school diploma

Tools

PTCB

Job description

Pacer Group is seeking a Pharmacy Coordinator 1 to support the pharmacy department in developing, coordinating, and maintaining the program. This remote role spans 6 months with potential extension, and follows a Mon-Fri 8:00 AM–4:00 PM schedule, paid on a W2 basis.

Responsibilities include handling prior authorization calls, formulary review, cost/utilization analysis, and provider education. Requires a high school diploma and 3+ years of pharmacy experience in managed care; Arizona license and