The Pharmacy Service Coordinator is responsible for being the primary contact and liaison for and between the company's medical partners and the pharmacy vendor for implementing and de-implementing client Rx benefits.
Primary duties may include, but are not limited to:
- Researches and interprets claims issues while ensuring good, accurate and timely customer service for our pharmacy clients.
- Understands the intricacies of prescription drug benefits and how they adjudicate.
- Understands and interprets client requests for new benefit designs.
- Coordinates, conducts and/or supports internal and external client meetings or training sessions as needed.
- Works with multiple departments and sources in order to accommodate the needs of our clients; this includes claim processing, customer service, & medical account management.
- Oversees benefit set up process to ensure pharmacy product changes occur with minimal disruption.
- Develops, reviews, and researches capabilities of pharmacy system to accommodate drug benefit design requested by clients or suggested by medical teams.
- This includes attendance and support for processes to review new plan design requests, i.e. Customer Exception Process and National Accounts Approval Process, and collaborating with Product development, Proposal Development, Customer Exception and Sales Departments.
- Create or coordinate the delivery of standard and custom reports for internal and external clients, such as claims, drug utilization and impact reports to our clients in compliance with performance guarantees and client requests.
- Requires a BA/BS degree and a minimum of 5 years of customer service, claims, and/or membership experience in healthcare and a minimum of 3 years related pharmacy experience; or any equivalent combination of education and experience which would provide an equivalent background.
- Working knowledge of pharmacy benefit management industry preferred.
Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Be part of an Extraordinary Team
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.
We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealthinc.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact firstname.lastname@example.org for assistance.