More jobs:
Pharmacy Operations Representative – Medicaid
Job in
Springfield, Sangamon County, Illinois, 62777, USA
Listed on 2026-07-29
Listing for:
Jobtailor
Full Time
position Listed on 2026-07-29
Job specializations:
-
Healthcare
Pharmacy Technician
Job Description & How to Apply Below
Responsibilities
- Provide assistance to pharmacists, pharmacy team, care coordinators, and the customer service team in the resolution of pharmacy-related issues to include claims
- Work closely with internal departments and external vendors to evaluate and resolve issues
- Support processes to ensure federal and state regulations and program requirements are met and maintained
- Communicate pharmacy related written and telephone inquiries with members, providers, pharmacies, and groups regarding benefits
- Licensed and unrestricted Pharmacy Technician/Certified Pharmacy Technician (CPhT)
- Bachelor's degree in Business or a related health care field OR 4 years work experience in a pharmacy/health care/managed care industry
- Verbal and written communication skills
- Managed care customer service experience
- Proficiency of MS product suite;
Word, Excel, Access, and database software - Drug information skills
- Handle multiple tasks and strong organizational skills.
- Retail, Hospital, Specialty Pharmacy, Pharmacy Benefits Manager, Health Plan experience (preferred)
- Telephone support to include members inquiries, providers, pharmacies and groups regarding benefits (preferred)
- Support through written and digital channels (preferred)
Effectively working across / collaborating with internal stakeholders such as Customer Service Team, PBM/Pharmacy, Providers, members to resolve pharmacy related gaps in care, coverage & claims submission issues (preferred) - Facilitate process for clinical & benefit overrides, Step Therapy and prior-authorization efforts in the PBM claims systems for Utilization Management (UM) and Clinical Services (preferred)
- Pharmacy Technician
- Certified Pharmacy Technician (CPhT)
- Drug information skills
- Managed care customer service
- Utilization Management (UM)
- Clinical Services
- Claims resolution
- Process facilitation
- Step Therapy
- Prior-authorization
- Verbal communication
- Written communication
- Organizational skills
- Collaboration
- Problem-solving
- Multi-tasking
- Licensed Pharmacy Technician
- Certified Pharmacy Technician (CPhT)
To View & Apply for jobs on this site that accept applications from your location or country, tap the button below to make a Search.
(If this job is in fact in your jurisdiction, then you may be using a Proxy or VPN to access this site, and to progress further, you should change your connectivity to another mobile device or PC).
(If this job is in fact in your jurisdiction, then you may be using a Proxy or VPN to access this site, and to progress further, you should change your connectivity to another mobile device or PC).
Search for further Jobs Here:
×