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Job Title: Pharmacy Coordinator NDC
Duration: 6 Months+
Job Descriptions:
Role Description
- Process prior authorization requests. Issue prior authorizations as appropriate through established protocols, policies and procedures. Communicate with the physicians' and pharmacies' approvals and denials by phone and/or letter as needed. Answer questions/requests and resolve issues from providers, pharmacists and staff.
- The resource will field questions regarding pharmacy benefit issues and communicate details of service through telephonic responses to physicians, pharmacists and Commonwealth staff. Issues addressed include prescription benefits, formulary issues, prescription claim processing, and prior authorizations. The resource ensures documentation of actions. Resolve routine provider pharmacy concerns.
- This includes answering questions from various sources (a member, physician, staff, etc.) regarding specific provider issues and as appropriate deciding on plans of action to resolve routine issues. Provide administrative support to the pharmacy team.
- This involves preparation and distribution of Policies & Procedures, committee agendas and minutes, and other correspondence as required. Document all communications appropriately. This includes documentation through the telephone call tracking system.
Minimum Qualifications
- Possess an Associate's Degree in a health-related field (i.e., Medical Assistant) or a certification as a Pharmacy Technician Have experience working for a Pharmacy Benefit Management (PBM) company or health plan in a managed care pharmacy department; working knowledge of retail pharmacy third party prescription processing. Have knowledge of drug categories, brand and generic names including pronunciation and spelling; knowledge of utilization management tools used for controlling pharmacy costs – i.e. quantity limits, prior authorization, step therapy, generic programs, etc. Ability to have a professional dialogue with a physician or a physician's staff. Basic computer skills to include, but not limited to, Microsoft Office Products.