Remote Pharmacy Support Specialist (NM Resident)

Molina Healthcare; Clayton (NM); Remote; USD 22,000 - 30,000; Full time

Job summary

Molina Healthcare is hiring a Pharmacy Customer Service Representative. This role is remote for residents of New Mexico and will support inbound and outbound calls from members, providers, and pharmacies to optimize medication-related outcomes and cost-effective care.

The shift is Monday through Friday, 11am–7:30pm MST, with responsibilities across prior authorizations, formulary guidance, and case support.

Qualifications

• 1+ year of customer service or call center experience.
• Strong verbal and written communication skills.
• Ability to work independently on special projects.
• Proficient with Microsoft Office and basic software applications.

Responsibilities

• Handle inbound/outbound pharmacy calls from members, providers and pharmacies.
• Coordinate and process pharmacy prior authorization requests and/or appeals.
• Explain POS claims adjudication and CMS/NCQA policies to stakeholders.
• Record calls accurately in the call tracking system and maintain quality metrics.
• Assist with clerical tasks and day-to-day call center operations.
• Provide information on formulary, copays, location services, and coverage determinations.

Skills

Customer service

Call center

Multi-tasking

Verbal communication

Written communication

Independence

Tools

Microsoft Office

Excel

Job description

Molina Healthcare is hiring a Pharmacy Customer Service Representative. This role is remote for residents of New Mexico and will support inbound and outbound calls from members, providers, and pharmacies to optimize medication-related outcomes and cost-effective care.

The shift is Monday through Friday, 11am–7:30pm MST, with responsibilities across prior authorizations, formulary guidance, and case support.