Job Description

Job Description

The Pharmacy Specialist is responsible for providing education, information and assistance to members, pharmacies, and physicians pertaining to their pharmacy benefits. In addition, the specialist will work directly with members, physicians, Facilities and manufacturers to coordinate enrollment for patient assistance programs along with facilitating patient care discussions with clinicians, pharmacists, and operational directors to determine the best approach in managing cost and clinical therapy for patients.

Primary Responsibilities:

• Assist in office duties which include intake of faxes, emails and phone calls.
• Maintain frequent phone contact with internal staff, external client, and external pharmacies
• Primary point of contact for member and physician inquiries
• Provides support to ensure efficient referral processing from intake to triaging of prescription coverage
• Coordinates and facilitates problem resolution for pharmacy and benefit issues
• Processing patient and prescriber prior authorization request in order to ensure access to therapy in a timely manner
• Utilize established protocols to determine root cause of escalated inquiries and ensures resolutions are provided in a timely manner
• Manage cases through Patient Assistance Programs to reduce patient and client cost
• Use high-level problem-solving skills to research cases independently, using professional judgement to make decisions
• Work independently to complete assigned pharmacy cases in accordance with standard operating policies and procedures and defined responsibilities to complete program enrollment, answer inquiries, and coordinate access to therapies
• Other related duties and projects, as assigned, to support business needs and the pharmacy team overall.
• Contribute to a positive, efficient, and safe work environment
• Proactive outreaches for formulary changes and alternate pharmacies.
• Take part in training opportunities.
• Keep our savings database up to date.
• Consistently work to support and grow the mission, vision, culture and values of the company

Requirements

Qualified candidates must possess the following skills:

• Knowledge of pharmacy products, programs and delivery channels, and industry/medical terminology.
• Strong computer skills and proficiency with Microsoft Office
• Excellent communication skills, both written and verbal
• Demonstrates a high degree of customer focus and attention to service
• Must be approachable, polite and have an impeccable work ethic, supporting the company's culture
• Comfortable with and be able to thrive in an ever-changing environment
• Ability to think through issues and bring forth effective solutions
• Conflict resolution
• Time-management and multi-tasking skills

Educational/Experience Requirements:

• High School Degree/GED Required
• Prefer 2 years of PBM or Pharmacy experience
• Prefer 2 years customer service
• Prefer Utah State Licensed Pharmacy Technician
• Prefer PTCB or ExCPT certified Pharmacy Technician

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