About The Position

This position provides processing and communication of Specialty and Non-Specialty medication prior authorization referrals reviewed by the Case Review Unit. This position collaborates with Customer Service, Benefits Verification and Pharmacy Operations to communicate referral status and determinations. This position is also responsible for fax processing and providing telephone call assistance for prescriber office staff, pharmacies and members based on program criteria. Maintaining complete, accurate and timely documentation of all appropriate information is necessary. This position also works closely with the Case Review Unit Clinician team for clinical support on daily functions. Other duties may also be assigned by the leadership team.

Requirements

  • Must be Hawaii resident.
  • 1+ years' experience in customer service or call center environment.
  • Must be able to work from home; this is a 100% work from home position.
  • Have wired high speed internet.

Nice To Haves

  • Previous experience in pharmacy or healthcare industry.
  • Associate's or Bachelor's Degree.
  • Pharmacy Technician License.

Responsibilities

  • Process and communicate Specialty and Non-Specialty medication prior authorization referrals.
  • Collaborate with Customer Service, Benefits Verification, and Pharmacy Operations.
  • Communicate referral status and determinations.
  • Handle fax processing and telephone call assistance for prescriber office staff, pharmacies, and members.
  • Maintain complete, accurate, and timely documentation of all information.
  • Work closely with the Case Review Unit Clinician team for clinical support.
  • Perform other duties as assigned by the leadership team.

Benefits

  • Affordable medical plan options.
  • 401(k) plan (including matching company contributions).
  • Employee stock purchase plan.
  • No-cost programs for wellness screenings, tobacco cessation, and weight management.
  • Confidential counseling and financial coaching.
  • Paid time off.
  • Flexible work schedules.
  • Family leave.
  • Dependent care resources.
  • Colleague assistance programs.
  • Tuition assistance.
  • Retiree medical access.
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