What are the responsibilities and job description for the Pharmacy Operations Representative position at Health Care Service Corporation?
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
The position supports pharmacists addressing medication inquiries, and working with internal and external entities (e.g., PBMs) to ensure timely and accurate resolutions to pharmacy-related issues. This role manages inbound calls, conducts member and provider outreach, and collaborates with pharmacists on account-based work to support medication management. Additionally, the position supports population health initiatives and participates in project-based, data-driven efforts to improve operational outcomes. As a valued member of our Pharmacy Operations team, you would also be responsible for providing assistance to the customer service team, pharmacy coordinators our members in resolution of various pharmacy issues. You would also be working with other internal departments and external vendors to evaluate and resolve the pharmacy related issues. This role is a Flex/Hybrid schedule requiring working 3 days either in the Richardson, TX; Albuquerque, NM; Chicago, IL or Helena, MT Headquarters offices and up to 2 days working from home. Core Business hours are 8:30 AM – 5:00 PM CST Monday – Friday
Job Requirements
This role is a Flex/Hybrid schedule requiring working 3 days either in the Richardson, TX; Albuquerque, NM; Chicago, IL or Helena, MT Headquarters offices and up to 2 days working from home. Core Business hours are 8:30 AM – 5:00 PM CST Monday – Friday.
Sponsorship is not available
Compensation: $38,100.00 - $80,000.00
Exact compensation may vary based on skills, experience, and location
HCSC Employment Statement
We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
To learn more about available benefits, please click https://careers.hcsc.com/totalrewards
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
The position supports pharmacists addressing medication inquiries, and working with internal and external entities (e.g., PBMs) to ensure timely and accurate resolutions to pharmacy-related issues. This role manages inbound calls, conducts member and provider outreach, and collaborates with pharmacists on account-based work to support medication management. Additionally, the position supports population health initiatives and participates in project-based, data-driven efforts to improve operational outcomes. As a valued member of our Pharmacy Operations team, you would also be responsible for providing assistance to the customer service team, pharmacy coordinators our members in resolution of various pharmacy issues. You would also be working with other internal departments and external vendors to evaluate and resolve the pharmacy related issues. This role is a Flex/Hybrid schedule requiring working 3 days either in the Richardson, TX; Albuquerque, NM; Chicago, IL or Helena, MT Headquarters offices and up to 2 days working from home. Core Business hours are 8:30 AM – 5:00 PM CST Monday – Friday
Job Requirements
- Certified Licensed and unrestricted Pharmacy Technician/Certified Pharmacy Technician (CPhT).
- Bachelor's degree in Business or a related health care field OR 4 years work experience in a pharmacy/health care/managed care industry.
- Verbal and written communication skills.
- Managed care customer service experience.
- Proficiency of MS product suite; Word, Excel, Access, and database software.
- Drug information skills.
- Handle multiple tasks and strong organizational skills.
- Retail, Hospital, Specialty Pharmacy, Pharmacy Benefits Manager, Health Plan experience.
- Telephone support to include members inquiries, providers, pharmacies, and groups regarding benefits.
- Support through written and digital channels.
- Effectively working across / collaborating with internal stakeholders such as Customer Service Team, PBM/Pharmacy, Providers, members to resolve pharmacy related gaps in care, coverage & claims submission issues.
- Facilitate process for clinical & benefit overrides, Step Therapy and prior-authorization efforts in the PBM claims systems for Utilization Management (UM) and Clinical Services.
- Innovative, creative and data driven skills needed
- Must be willing and able to work Phone Queue (take and process Inbound and Outbound Calls)
- Work Hours are in the Central Standard Time Zone (Monday – Friday 8:30 AM to 5 PM CST - working in the office 3 days and 2 days working from home) and must be willing to work in that CST zone.
This role is a Flex/Hybrid schedule requiring working 3 days either in the Richardson, TX; Albuquerque, NM; Chicago, IL or Helena, MT Headquarters offices and up to 2 days working from home. Core Business hours are 8:30 AM – 5:00 PM CST Monday – Friday.
Sponsorship is not available
Compensation: $38,100.00 - $80,000.00
Exact compensation may vary based on skills, experience, and location
HCSC Employment Statement
We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
To learn more about available benefits, please click https://careers.hcsc.com/totalrewards
Salary : $38,100 - $80,000