Administrative Skills, Analysis Skills, Best Practices, Call Centers, Call Volume, Claims Processing, Communication Skills, Compensation and Benefits, Data Analysis, Equity Securities, Federal Laws and Regulations, Health Plan, Interpersonal Skills, Medications, Multitasking, Operational Support, Organizational Skills, Persuasion Skills, Pharmacy, Prescription Drugs, Presentation/Verbal Skills, Research Skills, Retail, Standard Operating Procedures (SOP), State Laws and Regulations, Time Management, Training/Teaching
Position Description
Base pay is influenced by several factors including a candidate’s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may be modified in the future. Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more.
At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.”
The Pharmacy Program Specialist supports outbound calls and data/benefit analysis related to various clinical pharmacy programs. The Pharmacy Program Specialist performs advanced administrative/operational/member support duties.
Responsibilities and Qualifications
- Initiates and responds professionally to a high volume of calls in a timely and efficient manner, following standard operating procedures.
- Accurately establish and maintain member medication profiles for review by a Coordinator or Pharmacist.
- Collaborate with pharmacy peers, external and internal stakeholders on communication needs and best practices.
- Consistently produce quality of work that is above the industry average and meet service level expectations.
Skills:
Knowledge:
- Knowledge and experience in the pharmacy industry, health plan pharmacy functions, pharmacy benefits manager, and understanding prescription claims processing.
- Comprehension of State and Federal Laws/Regulations relating to the administration of Prescription Drug Benefits.
- Experience with presentation and training in a variety of audiences and settings.
- Proficient research and analytical skills.
Experience:
- 2 years of experience with a health plan pharmacy, call center, retail and/or alternate pharmacy setting experience.
Education and Certifications:
- High school diploma or equivalent.
Physical Demands:
- While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see. The employee must occasionally lift and/or move up to 5 pounds.
About Us
We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a caring team of supportive colleagues, and be encouraged to volunteer in your community. We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career. And by doing your best, you’ll help us live our mission of improving the health and well-being of our members and the communities in which they live.