Pharmacy Specialist

Pharmacy Specialist

Medical Services is seeking a Pharmacy Specialist for a remote position in North Dakota.

As our Pharmacy Specialist, you will serve as the primary contact for Medicaid providers and members when it comes to pharmacy claims processing. You will play a vital role in ensuring that patients receive their medications on time by troubleshooting pharmacy claims issues in real time and providing clear information about department drug use review policies. This is a front-facing position where you will be the go-to person when claims challenges arise, helping make the process smoother for both pharmacies and patients.

You will work with pharmacies across North Dakota to make sure claims and reimbursements for pharmacy services are processed through the ND Medicaid pharmacy claim payment system correctly. You will also support and collaborate with pharmacies that may experience difficulties processing claims due to point-of-sale rejections and help them resolve issues quickly. When needed, you will enter authorizations for medications, update pharmacies on claim and prior authorization statuses, coordinate with other departments, and prepare reports for both internal and external stakeholders.

To succeed in this role, strong verbal and written communication skills are key, as you will interact with a variety of stakeholders. You will need to simplify complex issues to get to the root of the problem, use a systematic approach when tackling multiple tasks, and follow established protocols to ensure consistency and accuracy. You should be someone who stays calm under pressure and can defuse situations when working with individuals who may be frustrated.

You should also be comfortable working with computers, navigating pharmacy software, and troubleshooting technical issues as they arise.

If you enjoy problem-solving, helping others, and making a real difference in ensuring North Dakotans receive timely access to their medications, this is the perfect opportunity for you.

To be considered for this position, you are required to have successfully completed some college coursework or be a licensed pharmacy technician. You must also have at least 4 years of work experience submitting or processing pharmacy or medical claims.

This position is Remote in North Dakota and bordering communities.

The State of North Dakota and this hiring agency do not discriminate on the basis of race, color, national origin, sex (including sexual orientation and gender identity), genetics, religion, age or disability in employment or the provisions of services and complies with the provisions of the North Dakota Human Rights Act. As an employer, the State of North Dakota prohibits smoking in all places of state employment in accordance with N.D.C.C. § 23-12-10.