Pharmacy Program Specialist II

Job Overview
Under the direction of the Manager, Managed Care Pharmacy Operation, the Pharmacy Program Specialist II supports the operational needs of the pharmacy team by managing prior authorization processes, coordinating communication between members and providers, and addressing issues with the Pharmacy Benefit Manager (PBM). The role requires a strong understanding of medical benefit drug coverage and adherence to regulatory timelines. The specialist also contributes to reporting, monitoring delegated PBM functions, and promoting member adherence, while delivering a high level of customer service.

QUALIFICATIONS:

Required Preferred Education/Specialized Training/Licensure: Bachelor’s degree in healthcare field, or in business administration Actively registered with the Texas State Board of Pharmacy as a certified pharmacy technician

Work Experience (Years and Area): Minimum Three (3) years’ experience with a Health Plan or PBM in related functions Strong experience with prior drug authorization process in a Health Plan or PBM

Pay: $23.46 - $29.32 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location: Hybrid remote in Houston, TX 77081