AddressDescription
The Pharmacy Service Coordinator is responsible 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.
Location: This position will work a hybrid model (1- 2 days in the office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.
How you will make an impact:
Researches and interprets claims issues while ensuring good, accurate and timely customer service for our 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.
Minimum Requirements:
Requires a BA/BS degree and a minimum of 5 years of customer service, claims, and/or membership experience in healthcare and a minimum of 3 years related pharmacy experience; or any equivalent combination of education and experience which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
Working knowledge of pharmacy benefit management industry preferred.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.comfor assistance.
