Pharmacy Services Specialist

100% Remote in the 28 states - North Carolina, Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming will be allowed to maintain their current residence and work remotely.

Screening Question:
1. The minimum internet speed is 1Mbps and 6Mbps download. We also need them to be directly connected to the router. Please confirm.
2. Tell me about a time when you found yourself in unfamiliar territory: a new situation. How did you adapt to this situation? What was the eventual outcome?

Description:

• Provides daily coordination of activities related to operations of pharmacy benefit management.
• Provides support to staff and coordinates tasks regarding the research, development, implementation and evaluation of programs, projects and initiatives.
• Serves as resource to staff and subject matter expert for assigned initiatives to provide input regarding pharmacy needs, impacts and projects.
• Resolves issues and escalates to management as appropriate; assists management in addressing clinical and contractual issues.
• Coordinates review, implementation, and quality assurance of benefit plan administration with internal stakeholders and PBM account team.
• Resolves or coordinates the resolution of escalated customer service inquiries and grievances internally and with PBM, including researching and authorizing/making pharmacy claim adjustments as appropriate.
• Coordinates the resolution of Pharmacy Coverage Determinations with Clinical Staff and/or external partners as appropriate
• Coordinates the resolution of pharmacy claim reconsiderations and appeals with the Appeals department and/or external partners as appropriate.
• Responsible for responding to and coordinating review and approval of RFPs, government program applications, and similar requests

Hiring Requirements

" High school diploma or GED
" 3+ years of experience in related field.

EEO:
Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.