Remote Specialty Pharmacy Liaison

Allied Benefit Systems, LLC; Chicago (IL); À distance; USD 50 000 - 55 000; Plein temps

Résumé du poste

Allied Benefit Systems, LLC seeks a Specialty Rx Coordinator to act as a liaison between retail and specialty pharmacy and prescribers. This remote role manages prior authorizations, negotiates pricing, handles referrals, and supports client/vendor communications across the revenue cycle.

The position requires at least 5 years of pharmacy benefits experience, knowledge of specialty medications, and strong communication and organizational skills.

Qualifications

• Bachelor’s degree or equivalent work experience required.
• At least 5 years of professional experience including comprehension of pharmacy and medical benefits, specialty medications, j-codes and their administration, limited distribution drugs as well as specialty pharmaceutical manager selection required.

Responsabilités

• Collect and review all submitted records related to pharmacy and/or medical prior authorization requests when the queue exceeds normal capacity.
• Arrange single case agreements, negotiate pricing, accurately process claims, and update all notes within the member’s associated QicLink page.
• Execute, manage, and provide on-going support of single case agreements.
• Assist and collaborate with Customer Service to improve processes, communications, and service between members, facilities, and vendors.
• Submit member referrals to third-party vendors managing specialty carve-out programs.
• Serves as liaison for external vendors when implementing specialty carve-out programs.
• Reviews current and newly requested vendor plan language to understand impact with governmental regulations.
• Ensure ongoing knowledge and compliance with all contracts beyond initial implementation and throughout the full revenue cycle.
• Collaborate with Plan Building, Customer Service, and other internal departments on the development and implementation of policies and group plan language related to a vendor.
• Management of escalated questions and status updates related to vendor relationships for the Client Executive, Client Service, and Customer Service teams.

Connaissances

Verbal communication

Written communication

Organizational skills

Analytical thinking

Problem solving

Microsoft Office

Formation

Bachelor’s degree or equivalent

Outils

Microsoft Office Suite

Description du poste

Allied Benefit Systems, LLC seeks a Specialty Rx Coordinator to act as a liaison between retail and specialty pharmacy and prescribers. This remote role manages prior authorizations, negotiates pricing, handles referrals, and supports client/vendor communications across the revenue cycle.

The position requires at least 5 years of pharmacy benefits experience, knowledge of specialty medications, and strong communication and organizational skills.