Pharmacy Analyst - Utilization Management

Henry Ford Health•Troy, MI

About The Position

As a Pharmacy Analyst, you will handle daily pharmacy duties, including drug claim adjudication issues, prior authorization, and pharmacy benefit inquiries. You will act as a subject matter expert in resolving pharmacy benefit coverage issues and coordinating prior authorization and exception processes, supporting members, patients, physicians, pharmacies, and internal teams. The role requires accurate and timely resolution of coverage issues and collaboration with internal and external stakeholders to provide exceptional service. Henry Ford Health offers opportunities to grow your career, collaborate with dedicated professionals, and engage in mission-driven work. The organization provides opportunities for continuous learning and development while contributing to its mission of exceptional care.

Requirements

High school diploma or G.E.D. equivalent.
Minimum of one year of previous pharmacy experience.
Strong understanding of medical/clinical and pharmacy terminology.
Working knowledge of personal computers and Microsoft Office.
Organizational and time management skills to prioritize multiple tasks.
Strong interpersonal communication skills and customer interaction experience.

Nice To Haves

Associate's degree.
State of Michigan Pharmacy Technician licensure.

Responsibilities

Resolve drug claim adjudication issues and prior authorization requests.
Handle pharmacy benefit inquiries from members, patients, physicians, and pharmacies.
Coordinate prior authorization and exception processes as a subject matter expert.
Ensure accurate and timely resolution of pharmacy benefit coverage issues.
Collaborate with internal and external stakeholders to provide exceptional service.