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Pharmacy Program Specialist
JOB SUMMARYUnder the direction of the Director of Pharmacy Analytics, functions as a Pharmacy Program Specialist in the Pharmacy Analytics department. Provides efficient and accurate responses to external customers (physicians, office staff, pharmacy providers, members, and brokers), and internal team members. Resolves outpatient pharmacy benefit coverage and prescription claim problems. Communicates drug formulary guidelines, including drug formulary alternatives, prior authorization criteria, and group/member eligibility problems. JOB SPECIFICATIONS AND CORE COMPETENCIESAssist with processing medication prior authorization and appeal requests within required t
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