Pharmacy Specialist Level 1
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Overview
Remote
On-site
Compensation
$17-$19/hour
Job Description
Our client, is a Health Insurance company, is looking for a Pharmacy Specialist Level 1 for their Newark, NJ/Hybrid location.Responsibilities:
- This position is responsible for receiving verbal and written requests for prior authorization from pharmacists, physicians and/or patients and is responsible for supporting and assisting in the coordination of Pharmacy Services activities including claim utilization analysis, prescription plan design, ad-hoc reporting, correspondence and special projects. Must maintain performance in compliance with organizational or department goals and in compliance with regulatory agencies
- Process prior authorizations received via prior authorization help line, by evaluating the medical necessity/appropriateness for specific drugs and based on medical criteria.
- Directly interact with members physician office staff, pharmacies and internal stake holders for eligibility, coverage determination claims issues.
- Conduct intervention with physician & pharmacy office staff to facilitate formulary compliance and generic dispensing.
- Process appeals complaints executive inquiries and compliance related issues.
- Provide recommendations to increase efficiency, accuracy and productivity in the department.
- Process ad hoc request for information or reports from stakeholders.
- Participate in client member and employee training to ensure practical understanding of pharmacy services programs and operations.
- Assist in the day-to-day business functions of the pharmacy department as well as the Medication Therapy Management program.
- Provide support to various clinical programs within the pharmacy department.
- Prefers a Bachelor's degree from an accredited college or university in Health Care Management, Business or Pharmaceutical Administration.
- Requires minimum of two (2) years experience in third party prescription program claim adjudication.
- Requires minimum of two (2) years experience as a Pharmacy Utilization Management Specialist.
- Requires prior customer service/service quality initiative experience.
- Health Benefits
- Referral Program
- Excellent growth and advancement opportunities
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FAQs About Pharmacy Specialist Level 1 Jobs at Iconma
What is the work location for this position at Iconma?
This job at Iconma is located in Newark, NY, according to the details provided by the employer. Some roles may also include multiple work locations depending on the requirement.
What pay range can candidates expect for this role at Iconma?
Candidates can expect a pay range of $16.55–$19.31 per hour for this role.
What employment applies to this position at Iconma?
The employer has not provided this information. This may be discussed during the hiring process.
What is the process to apply for this position at Iconma?
You can apply for this role at Iconma either through Sonara's automated application system, which helps you submit applications 10X faster with minimal effort, or by applying manually using the direct link on the job page.