Pharmacy Operations Rep

About the Role

This position supports pharmacists and pharmacy coordinators in resolving medication claims and inquiries, working with internal teams and external vendors (e.g., PBMs) to ensure timely and accurate issue resolution. The 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.

Key Responsibilities

• Provide assistance to pharmacists and pharmacy coordinators in resolution of claims, pricing, coding.
• Work with internal departments and external vendors to evaluate and resolve pharmacy related issues.
• Support pharmacists and pharmacy coordinators in resolving medication claims and inquiries.
• Work with internal teams and external vendors (e.g., PBMs) to ensure timely and accurate issue resolution.
• Manage inbound calls.
• Conduct member and provider outreach.
• Collaborate with pharmacists on account-based work to support medication management.
• Support population health initiatives.
• Participate in project-based, data-driven efforts to improve operational outcomes.

Requirements & Tech Stack

• Microsoft Word, spreadsheets, and database software
• PBMs (as external vendors)

Qualifications

• 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
• Verbal and written communication skills
• Managed care customer service experience
• Drug information skills
• Handle multiple tasks and strong organizational skills

This is a Flex (Hybrid) role: requires 3 days in office; 2 days remote

Compensation: $40,500.00 - $72,500.00

Exact compensation may vary based on skills, experience, and location