Vacancy expired!
Pharmacy Service Coord/Coord Sr-PS29982Location: Mason, Ohio, United StatesNewRequisition #: PS29982Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.Pharmacy Service Coordinator-in office, Mason OH preferred but also available in office in Atlanta GA, Chicago IL, Las Vegas NV, Louisville KY, Minneapolis MN, Morristown NJ, St Louis MO, Virginia Beach VA or Wallingford CTResponsible 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 Anthem 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.
Pharmacy Service Coordinator Sr-in office, Mason OH preferred but also available in office in Atlanta GA, Chicago IL, Las Vegas NV, Louisville KY, Minneapolis MN, Morristown NJ, St Louis MO, Virginia Beach VA or Wallingford CTResponsible for overseeing the flow of operational functions & activities assisting in the development & implementation of complex pharmacy benefit products. Primary duties may include, but are not limited to:
Understands the intricacies of complex 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.
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 complex 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.
Pharmacy Services CoordinatorRequires:
BA/BS degree
5 years of customer service, claims, and/or membership experience in healthcare
3 years related pharmacy experience with working knowledge of the pharmacy benefit management industry
or any equivalent combination of education and experience, which would provide an equivalent background.
Pharmacy Services Coordinator SrRequires:
BA/BS in related field
1-3 years of Pharmacy Services Coordinator experience and 5 years of customer service/claims/membership experience in healthcare
3 years related pharmacy experience with working knowledge of the pharmacy benefit management industry
or any equivalent combination of education and experience, which would provide an equivalent background.
Travel required.
This position is posted as a job family and the selected candidate will be placed into the job level commensurate with their experienceAnthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.
