Position Summary: The Coordinator, Pharmacy Benefits shall support the efforts of the clinical pharmacy teams of both Florida Complete Care’s Medicare Part D and Florida Community Care’s Medicaid pharmacy benefit programs. The successful candidate will be able to collaborate with prescribers and targeted beneficiaries to ensure appropriate payment determination, evidence-based drug selection, and resolve medication-related problems.

Essential Functions:

• Support basic data analytic activities and tracking of metrics, claims and interventions.
• Assist with preparation and documentation of responses to regulatory audits.
• Monitor medication therapy management (MTM) services through prescriber follow-up and collaborations with other departments.
• Document and record oversight/activities in appropriate databases/software to ensure compliance with CMS and Florida Medicaid requirements.
• Consult with pharmacists and/or physicians regarding the use of medications and advise of appropriate formulary alternatives when requested.
• Respond to inquiries from other departments, physicians, and members related to formulary and prescription benefits.
• Engage in drug utilization review (DUR) by supporting letter campaigns, and telephonic outreach to members/providers. 
• Participate in various pharmacy benefit-related projects. Complete assigned reports for pharmacist review as needed.
• Complete member-related tasks within the same business day whenever possible. Address member concerns in a timely manner.
• Refer all prescribers (MD, DO, APRN etc.) and customer calls related to medical questions to the Pharmacist.

Education & Experience:

• State of Florida Registered Pharmacy Technician License (RPT) required.
• Managed Care Pharmacy experience, required. 
• PBM operations experience, preferred.

Required Skills:

• Bilingual (English/Spanish), preferred 
• Knowledge of pharmaceutical generic and brand names 
• Strong Microsoft software and computer skills (Word, Excel, PowerPoint, Access, Outlook) 
• Programming or Reporting software skills, desired