Campus Pride Jobs

JOB REQUIREMENTS: Pharmacy Specialist Job Locations US-WI ID 2024-2061 Category Clinical Services Type Regular Full-Time Overview Do you have a passion for providing exceptional customer experience? Do you have an interest in improving the health of others by collaborating with team members to solve problems that support the needs of our customers? If so, please consider applying for our Pharmacy Specialist position! Quartz is looking for an organized, adaptable Pharmacy Technician to work as a Pharmacy Specialist. This position will be responsible for processing pharmacy related coverage decisions for all utilization management requests in accordance with standards for accuracy, timeliness, productivity, and regulatory requirements. Also, this position with will be interacting with both internal and external customers to provide and obtain information and ensures the delivery of outstanding service and quality. Benefits: Typical work week; Monday - Friday, 8 am - 5pm. May vary due to urgent business needs. Opportunities for learning new skills and advancement Starting pay rate: \$20 /hr. based on skills and experience + robust total rewards package. Responsibilities Process and finalize all requests within turnaround time (TAT) utilizing guidelines and other applicable regulatory requirements Enter coverage requests into the system and prioritize as required Check formulary alternatives, review tried and failed medications Utilize drug references and verify the drug being requested is indicated and approved for the condition Document all related information regarding the coverage decision Respond to coverage requests by faxing status to the physician Conforms to defined roles & responsibilities and rules of engagement between coverage decisions processing and clinical decision making Partners with assigned clinical pharmacists to accurately and efficiently complete coverage decisions Accountable to achieve productivity and accuracy standards Analyzes, researches, and resolves coverage decision processing issues including making written or telephone inquiries to obtain information from PBM, members, physicians, or pharmacies. Qualifications High School Diploma or equivalency is required; Bachelor\'s degree in a related field preferred. 3+ years previous experience in a health care setting, managed care, PBM, or pharmacy setting is required. Managed Health Care, Pharmacy and Claims Billing, Medicare Part D or a related field experience is preferred. Understanding of managed pharmacy benefit concepts including formularies, prior authorizations, and claim adjudication. Understand medical terminology and Medicare regulation. Certified Pharmacy Technician (CPHT) or obtain CPHT within 12 months of hire. Excellent oral and written communication... For full info follow application link. Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individual with Disabilities ***** APPLICATION INSTRUCTIONS: Apply Online: ipc.us/t/A3D2172815504CC1