Elevance Health - Woburn, MA
posted about 2 months ago
Full-time - Mid Level
Woburn, MA
11-50 employees
Insurance Carriers and Related Activities
About the position
The Pharmacy Services Coordinator at Elevance Health serves as the primary contact and liaison between the company's medical partners and pharmacy vendors, focusing on the implementation and de-implementation of client prescription benefits. This role involves ensuring accurate and timely customer service, understanding prescription drug benefits, coordinating client meetings, and overseeing the benefit setup process to minimize disruptions.
Responsibilities
- Researches and interprets claims issues while ensuring good, accurate and timely customer service for pharmacy clients.
- Understands the intricacies of prescription drug benefits and how they adjudicate.
- 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 to accommodate client needs, including claim processing and customer service.
- Oversees the benefit setup process to ensure pharmacy product changes occur with minimal disruption.
- Develops, reviews, and researches capabilities of pharmacy systems to accommodate drug benefit designs requested by clients or suggested by medical teams.
- Creates or coordinates the delivery of standard and custom reports for internal and external clients.
Requirements
- BA/BS degree and a minimum of 5 years of customer service, claims, and/or membership experience in healthcare.
- Minimum of 3 years related pharmacy experience or equivalent combination of education and experience.
Nice-to-haves
- Working knowledge of pharmacy benefit management industry preferred.
Benefits
- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical benefits
- Dental benefits
- Vision benefits
- Short and long term disability benefits
- 401(k) with matching
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
