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Position Overview:
Coordinate application of pharmacy services and benefits as an integral contributor on the
pharmacy team. Handle pharmacy-related inquiries and communicate benefit determinations.
Provide pharmacy services help desk support to pharmacies, providers, and members. Perform
pharmacy authorization and claim processing services.
● Talent can sit out of Bend, Springfield OR Boise
● Needs to go onsite first couple of days to get onboarded and oriented, and then will WFH
the remainder of the contract
3-5 Must Have Skills/Qualifications
● Knowledge with Microsoft Office products including Word, Excel, and Outlook.
● Pharm Tech experience
● Pharm Tech license in the state the talent lives in (ID or OR)
Soft Skill/Attribute Requirements
● Problem solving skills
● Critical thinking skills
● Communication skills
● Team player - needs to communicate amongst team on a daily basis - in teams chat
● Independent worker
Selling Points
● The ability to work onsite or WFH - flexible with remote, hybrid or in-person - just needs to
have the ability to come onsite first week of training
● Growing and reputable organization
● Opportunity for a permanent role
Schedule/Shift:
● REMOTE M-F 9-5
Overview of Responsibilities:
● Act as principal contact regarding drug authorizations and system overrides. Help to
resolve pharmacy services and benefits inquiries through skillful knowledge of the
pharmacy claims, medical claims, and utilization management platforms.
● Initiate clinical review and decision-making of authorization requests under the guidance
of clinical pharmacists.
● Serve as a primary resource to members and providers for pharmacy questions related to
the health plan and in navigating through the health systems.
● Provide support and maintenance for department communication tools (ie. Sharepoint), as
applicable.
● Assist Pharmacy Services Leadership to ensure compliance with all rules and regulations as
applicable.