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Pharmacy Specialist - Wisconsin Rapids Wisconsin
Company: Quartz Location: Wisconsin Rapids, Wisconsin
Posted On: 05/02/2024
Overview Do you have a passion for providing exceptional customer experience? Do you have an interest in improving the health of others by collaborating with team members to solve problems that support the needs of our customers? If so, please consider applying for our Pharmacy Specialist position! Quartz is looking for an organized, adaptable Pharmacy Technician to work as a Pharmacy Specialist. This position will be responsible for processing pharmacy related coverage decisions for all utilization management requests in accordance with standards for accuracy, timeliness, productivity, and regulatory requirements. Also, this position with will be interacting with both internal and external customers to provide and obtain information and ensures the delivery of outstanding service and quality. Benefits: - Typical work week; Monday - Friday, 8 am - 5pm. May vary due to urgent business needs.
- Opportunities for learning new skills and advancement
- Starting pay rate: $20 /hr. based on skills and experience + robust total rewards package. Responsibilities
- Process and finalize all requests within turnaround time (TAT) utilizing guidelines and other applicable regulatory requirements
- Enter coverage requests into the system and prioritize as required
- Check formulary alternatives, review tried and failed medications
- Utilize drug references and verify the drug being requested is indicated and approved for the condition
- Document all related information regarding the coverage decision
- Respond to coverage requests by faxing status to the physician
- Conforms to defined roles & responsibilities and rules of engagement between coverage decisions processing and clinical decision making
- Partners with assigned clinical pharmacists to accurately and efficiently complete coverage decisions
- Accountable to achieve productivity and accuracy standards
- Analyzes, researches, and resolves coverage decision processing issues including making written or telephone inquiries to obtain information from PBM, members, physicians, or pharmacies. Qualifications
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