Pharmacy Operations Representative – Remote
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.
Job Summary
Primary responsibility for the Pharmacy Operations Representative will be conducting the clinical review of prior authorizations using Smart UM Clinical. This position is responsible for reviewing medical policy for high dollar infusion and injections within the medical benefit division. The individual is also responsible for proactive outreach to provider offices to gather additional information and maintaining the process for prior-authorization review within a timely manner to meet plan required turnaround times.
Job Requirements:
- Bachelors degree in Business or a related health care field or four years work experience in a health care/insurance industry (or equivalent)
- Certified Pharmacy Technician required
- Licensed Pharmacy Technician required
- Verbal and written communication skills
- Managed care customer service experience
- Demonstrated proficiency of word processing spreadsheets and database software
- Drug information skills
- Handle multiple tasks and strong organizational skills
- Microsoft excel experience strongly preferred
- Microsoft Outlook and Team experience preferred
Additional Job Details:
- Work Schedule: Monday – Friday any 8-hour shift between the hours of 7:00am-6:00pm MST
- Rotating Weekends are required, typically twice a year
- This is a Telecommute (Remote) role: Must reside within 250 miles of the office locations listed
- Sponsorship: Sponsorship is not available
Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!
Pay Transparency Statement:
At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.
The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.
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.
Base Pay Range
$37,400.00 – $78,400.00
Originally posted on Himalayas
