Job description
Overview:
The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
Responsibilities:
The Pharmacy Specialist will perform duties to support the efforts of Elderplan Pharmacy Department in the development, coordination, and maintenance of the plan’s pharmacy program. These duties involve administrative tasks and outreach calls to members, providers, and pharmacies as directed by the supervisor. Reviews and identifies opportunities for FWA (fraud, waste, and abuse) control through a review of high-cost drug claims as directed by pharmacists. All outreach activities, documents and reporting requirements are prepared and conducted in a professional and well-coordinated manner to comply with all Part D regulations and guidance.
Qualifications:
- Bachelor's degree required
- 1-2 years experience of general office or administrative, pharmacy and/or pharmaceutical managed care or insurance environment
- Strong interpersonal and organizational skills
- Bilingual English/Spanish a plus
- Excellent written and verbal communication skills
- Proficiency Excel, Word, Visio required
- Experience in Medicare, Medicaid and/or Pharmacy retail strongly preferred
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