Remote Pharmacy Medication Management Specialist

Inland-Empire-Health-Plan-; Rancho Cucamonga (CA); Remote; USD 37,000 - 50,000; Full time

Job summary

Inland Empire Health Plan is seeking a Pharmacy Medication Management Specialist to perform medication reconciliations, CMRS, and TMRs under the supervision of the Pharmacy Operations Supervisor. You will document histories, respond to provider inquiries, and coordinate prior authorizations within policy and regulatory requirements.

Responsibilities include reviewing authorizations, interfacing with PBM/claims systems, and supporting quality goals through LEAN projects and care coordination.

Qualifications

• Education & requirements include one or more years as a pharmacy technician.
• Active California Pharmacy Technician license required.
• Experience in PBM settings is preferred.

Responsibilities

• Conduct technical review of drug authorizations and provide clinical recommendations.
• Process prior authorizations within regulatory turnaround times.
• Prepare medication reconciliation reviews, CMRS and TMRs for pharmacist review.
• Provide excellent customer service on inbound/outbound calls to providers/mMembers.
• Document medication histories accurately in EMRs and claims systems.
• Collaborate with providers and pharmacy teams on formulary issues and procedures.
• Support quality improvement efforts and participate in team projects.

Skills

Pharmaceutical terminology

Organizational skills

Verbal communication

Written communication

Interpersonal skills

Adaptability

Attention to detail

Critical thinking

Education

High School Diploma or GED

Associate or Bachelor’s degree

Tools

Microsoft Excel

Job description

Inland Empire Health Plan is seeking a Pharmacy Medication Management Specialist to perform medication reconciliations, CMRS, and TMRs under the supervision of the Pharmacy Operations Supervisor. You will document histories, respond to provider inquiries, and coordinate prior authorizations within policy and regulatory requirements.

Responsibilities include reviewing authorizations, interfacing with PBM/claims systems, and supporting quality goals through LEAN projects and care coordination.