pharmacy benefits specialist

Henry Ford Health

<div><div><p>Join the growing <b>Henry Ford Health Pharmacy Advantage</b> team as a <b>Full-Time Pharmacy Benefits Specialist!</b> Make a meaningful impact on patient care while enjoying a <b>flexible hybrid schedule</b> (In-person + Remote). This role offers a <b>$2,500 sign-on bonus</b> and <b>comprehensive full-time benefits</b>. You'll support patients and providers by helping navigate pharmacy benefits and coordinating prescription services. Be part of a mission-driven team that's improving lives every day! This role is based out of Rochester Hills close door Pharmacy department here at Henry Ford Health.</p><p><b>
GENERAL SUMMARY:</b></p><p>
***Eligible for $2,500 Sign on Bonus***</p><p>
Location: Rochester Hills, MI</p><p>
Schedule: Full- Time Day Shifts</p><p>
In this role, you will collaborate with our Specialty Department within the Henry Ford Health Pharmacy Advantage Team.</p><p><b>
Specialty Department: </b>The Pharmacy Benefits Specialist within the Specialty Department provides patient-centered services for specialty medications. Responsibilities include prescription intake, insurance benefits investigation, prior authorization management, financial assistance support, refill adherence, and delivery coordination. Team members collaborate closely with patients, providers, and insurers to navigate the specialty medication process, ensuring timely care and a positive patient experience. This office-based role requires strong computer and phone communication skills. We are looking for dedicated, compassionate individuals ready to join a collaborative, quality-focused team committed to patient success.</p><p></p><p><i><br>
This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and duties. It should be understood, therefore, that employees may be asked to perform job-related duties beyond those explicitly described above.</i></p>
<div><p><b>EDUCATION/EXPERIENCE REQUIRED:</b></p><ul><li>
Requires a High school diploma or G.E.D. Associates degree preferred</li><li>
Requires State of Michigan Pharmacy Technician License.</li><li>
Requires a minimum of two years of previous pharmacy technician experience.</li><li>
Previous experience as a specialty pharmacy technician preferred.</li></ul>
 </div></div><div><div><div><div><h4 class="jobSectionHeader"><b>Additional Details</b></h4>
<div><p>
This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.</p></div>
</div>
</div></div><div><div><div><h4 class="jobSectionHeader"><b>Overview</b></h4>
<div><p>
Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services &ndash; from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford&rsquo;s care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation&rsquo;s most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. Learn more at henryford.com/careers.</p></div>
</div>
</div></div><div><div><div><h4 class="jobSectionHeader"><b>Benefits</b></h4><div><p><br>
</p><p>The health and overall well-being of our team members is our priority. That&rsquo;s why we offer support in the various components of our team&rsquo;s well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. Our team members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees classified as contingent status are not eligible for benefits.
</p></div></div></div></div><div><div><div><h4 class="jobSectionHeader"><b>Equal Employment Opportunity/Affirmative Action Employer</b></h4>
<div><p>
 Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is</p>
<p>
 committed to the hiring, advancement and fair treatment of all individuals without regard to</p>
<p>
 race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,</p>
<p>
 weight, marital status, family status, gender identity, sexual orientation, and genetic information,</p>
<p>
 or any other protected status in accordance with applicable federal and state laws.</p></div></div></div></div></div></div>

Pharmacy Benefits Specialist - Specialty - Full Time Days - Pharmacy Advantage

<div><div><p>Join the growing <b>Henry Ford Health Pharmacy Advantage</b> team as a <b>Full-Time Pharmacy Benefits Specialist!</b> Make a meaningful impact on patient care while enjoying a <b>flexible hybrid schedule</b> (In-person + Remote). This role offers a <b>$2,500 sign-on bonus</b> and <b>comprehensive full-time benefits</b>. You'll support patients and providers by helping navigate pharmacy benefits and coordinating prescription services. Be part of a mission-driven team that's improving lives every day! This role is based out of Rochester Hills close door Pharmacy department here at Henry Ford Health.</p><p><b>
GENERAL SUMMARY:</b></p><p>
***Eligible for $2,500 Sign on Bonus***</p><p>
Location: Rochester Hills, MI</p><p>
Schedule: Full- Time Day Shifts</p><p>
In this role, you will collaborate with our Mail Order Services Department within the Henry Ford Health Pharmacy Advantage Team.</p><p><b>
Mail Order Services Department: </b>The Pharmacy Benefits Specialist within the Mail Order Services team will support patients with maintenance medications. Responsibilities include prescription intake, adherence reminder calls, delivery coordination, insurance benefits investigation, prior authorization management, and financial assistance research. The team monitors medication adherence across multiple patient populations, including Medicare, Medicaid, Transplant, Transition of Care, and Commercial. By identifying and addressing patient barriers, our team enhances adherence and health outcomes while delivering exceptional service. This office-based position requires strong computer and phone communication skills. We are seeking career-focused individuals to join our growing, patient-centered, and collaborative pharmacy team.</p><p><i>
This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and duties. It should be understood, therefore, that employees may be asked to perform job-related duties beyond those explicitly described above.</i></p>
<div><p><b>EDUCATION/EXPERIENCE REQUIRED:</b></p><ul><li>
Requires a High school diploma or G.E.D. Associates degree preferred</li><li>
Requires State of Michigan Pharmacy Technician License.</li><li>
Requires a minimum of two years of previous pharmacy technician experience.</li><li>
Previous experience as a specialty pharmacy technician preferred.</li></ul><p></p><p><br>
#IND3</p>
 </div></div><div><div><div><div><h4 class="jobSectionHeader"><b>Additional Details</b></h4>
<div><p>
This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.</p></div>
</div>
</div></div><div><div><div><h4 class="jobSectionHeader"><b>Overview</b></h4>
<div><p>
Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services &ndash; from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford&rsquo;s care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation&rsquo;s most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. Learn more at henryford.com/careers.</p></div>
</div>
</div></div><div><div><div><h4 class="jobSectionHeader"><b>Benefits</b></h4><div><p><br>
</p><p>The health and overall well-being of our team members is our priority. That&rsquo;s why we offer support in the various components of our team&rsquo;s well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. Our team members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees classified as contingent status are not eligible for benefits.
</p></div></div></div></div><div><div><div><h4 class="jobSectionHeader"><b>Equal Employment Opportunity/Affirmative Action Employer</b></h4>
<div><p>
 Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is</p>
<p>
 committed to the hiring, advancement and fair treatment of all individuals without regard to</p>
<p>
 race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,</p>
<p>
 weight, marital status, family status, gender identity, sexual orientation, and genetic information,</p>
<p>
 or any other protected status in accordance with applicable federal and state laws.</p></div></div></div></div></div></div>

Pharmacy Benefits Specialist - Mail Order Services - Full Time Days - Rochester Hills

EmblemHealth

<div></div><div><div>Summary of Job</div><div>
Support eligibility and benefits configuration and deployment, including collaboration with pharmacy benefits manager (PBM) and Cognizant, formulary teams, for configuration. Responsible for Quality Assurance and Testing for operations and implementations. Coordinate and manage the pharmacy plan/ benefit design implementation process in partnership with PBM to ensure the accuracy and timeliness of members&rsquo; pharmacy benefit administration for superior member experience.</div><div>
Responsibilities</div><ul><li>
Maintain in-depth understanding of and ability to create and maintain plan/benefit design rules and limitations to include: Adjudication rules, Clinical rules, Payment rules, and Plan/group management.<br>
</li><li>
Partner with Sales and Product teams, assist in developing pharmacy benefit plan designs, meeting client requests, Health Plan strategic/ business parameters and all regulatory and other oversight agencies&rsquo; requirements.<br>
</li><li>
Responsible for creating and maintaining plan/benefit design documentation to support internal and external requirements<br>
</li><li>
Lead communication and coordination between Health Plan and PBM for receipt of required information for claims adjudication system set up, reporting and claim adjudication process.<br>
</li><li>
Assess all requests for new/ changes to plan benefit information to ensure compatibility with PBM claim adjudication logic.<br>
</li><li>
Submit accurate and complete requests to the PBM for new and changing benefit plan designs.<br>
</li><li>
Test pharmacy benefit plan designs for accuracy and alignment with business requirements.<br>
</li><li>
Serve as liaison to PBM to troubleshoot and resolve benefit-related questions/ issues, researching plan/benefit design options and requirements.<br>
</li><li>
Participate in PBM implementation meetings as required.<br>
</li><li>
Review and approve PBM benefit set up requirements.<br>
</li><li>
Perform claim testing to ensure accurate claim adjudication.<br>
</li><li>
Work with the pharmacy clinical team to implement formulary updates in the claim adjudication system.<br>
</li><li>
Participate in the research and resolution of claims adjudication-related discrepancies, errors, and problems.<br>
</li><li>
Acts as a resource to operational areas in support of the pharmacy claims adjudication process and responding to issues related to plan/ benefit design.<br>
</li><li>
Conduct quarterly audits of pharmacy benefit configurations to ensure alignment with plan design, regulatory requirements, and accurate claim adjudication across all lines of business.<br>
</li><li>
Recommend streamlined work processes and systems that impact plan/ benefit design to create efficiency and quality outcomes.<br>
</li><li>
Maintain acceptable and appropriate quality levels and production SLA response time.<br>
</li><li>
Perform other projects and duties as assigned</li></ul>
<div><div>Qualifications</div><ul><li>
Bachelor&rsquo;s degree.<br>
</li><li>
Pharmacy Technician Certification (Required)<br>
</li><li>
Additional years of related experience may be considered in lieu of degree (Required)<br>
</li><li>
Ability to perform in office environment with extended periods of sitting, using telephone, and viewing computer screens (Required)<br>
</li><li>
Ability to prioritize tasks daily and trouble shoot urgent customer issues to successful completion (Required)<br>
</li><li>
Advanced knowledge of MS Office - Word, Excel, PowerPoint, Outlook, Teams, SharePoint, etc. (Required)<br>
</li><li>
Exceptional problem solving, analytical, interpersonal and communication skills to resolve issues within Operations (Required)<br>
</li><li>
Professionally skilled in verbal and written communication (Required)<br>
</li><li>
Meticulous organization skills, with the ability to multi-task, and ability to make sound decisions in a timely and independent manner (Required)</li></ul>
</div><div><p>Additional Information
</p><ul><li>Requisition ID: 1000003022</li>
<li>Hiring Range: $56,160-$99,360</li></ul></div></div>

Pharmacy Benefits Operations Specialist - Remote

Actalent

<div>
 <strong>
  Job Title: Pharmacy Prior Authorization Specialist
  <br/>
  <br/>
 </strong>
 <strong>
  Job Description
  <br/>
  <br/>
 </strong>
 This role focuses on processing and managing pharmacy coverage determination and prior authorization requests in a remote environment. The Pharmacy Prior Authorization Specialist reviews requests from providers, gathers necessary clinical information, applies defined criteria to approve requests when appropriate, and documents decisions in the pharmacy benefit management (PBM) system. The position requires strong attention to detail, excellent communication skills, and the ability to work effectively with prescribers, providers, members, and internal teams.
 <br/>
 <br/>
 <strong>
  Responsibilities
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Track and triage coverage determination requests submitted by providers and determine when a pharmacist review is required.
  </li>
  <li>
   Obtain verbal authorizations and request detailed clinical information from prescribers to support coverage determinations.
  </li>
  <li>
   Review and approve coverage determination requests based on defined clinical and plan criteria.
  </li>
  <li>
   Enter and document coverage determination decisions accurately in the PBM system.
  </li>
  <li>
   Notify providers and members of coverage determination decisions in a clear and timely manner.
  </li>
  <li>
   Respond to client inquiries regarding authorization approvals and PBM online applications.
  </li>
  <li>
   Refer coverage determination requests for specialty drugs to the appropriate delegated vendor or client for processing.
  </li>
  <li>
   Contact providers for additional information when needed to complete coverage determination reviews.
  </li>
  <li>
   Communicate coverage determination outcomes to physicians, providers, and members, ensuring they understand the decision and next steps.
  </li>
  <li>
   Maintain a high level of accuracy and productivity while handling a large volume of prior authorization and coverage determination requests.
  </li>
  <li>
   Collaborate with team members and leadership to support process improvements and ensure compliance with managed care and Medicare/Medicaid requirements.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Essential Skills
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Current or recent experience in a pharmacy or pharmacy-related environment.
  </li>
  <li>
   Pharmacy technician license, with the ability to apply pharmacy knowledge to prior authorization processes.
  </li>
  <li>
   Hands-on experience with prior authorizations and coverage determination workflows.
  </li>
  <li>
   Strong data entry skills with high accuracy and attention to detail.
  </li>
  <li>
   Customer service experience, with the ability to communicate professionally with providers, prescribers, and members.
  </li>
  <li>
   Proficiency with Microsoft applications, including the ability to navigate and document information in multiple systems.
  </li>
  <li>
   Experience working within managed care settings, including familiarity with health plan and PBM operations.
  </li>
  <li>
   Knowledge of Medicare and Medicaid pharmacy benefits and authorization requirements.
  </li>
  <li>
   Ability to work effectively in a remote environment, using computer-based tools and communication platforms.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Additional Skills &amp; Qualifications
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Prior experience handling pharmacy benefit prior authorizations in a PBM or managed care organization.
  </li>
  <li>
   Comfort working with PBM online applications and authorization systems.
  </li>
  <li>
   Strong organizational skills to manage multiple coverage determination requests simultaneously.
  </li>
  <li>
   Effective verbal communication skills for obtaining clinical information and providing clear explanations of decisions.
  </li>
  <li>
   Ability to work both independently and collaboratively in a remote team setting.
  </li>
  <li>
   Adaptability to changing processes, criteria, and system updates related to managed care and government programs.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Work Environment
  <br/>
  <br/>
 </strong>
 This position operates in a 100% remote work environment and requires a reliable home office setup with appropriate computer and internet access. Standard start times range from as early as 8:00 a.m. EST to no later than 10:00 a.m. EST, with a one-hour lunch break during the regular schedule. The training schedule runs from 10:00 a.m. to 6:30 p.m. EST, Monday through Friday, with a 30-minute unpaid lunch. After training, the role includes rotating weekend coverage every 4 to 6 weeks. Work is computer-based, involving extensive use of PBM systems, Microsoft applications, and online communication tools, and requires sustained focus, accuracy, and professionalism in all interactions.
 <br/>
 <br/>
 <strong>
  Job Type &amp; Location
  <br/>
  <br/>
 </strong>
 This is a Contract to Hire position based out of Augusta, GA.
 <br/>
 <br/>
 <strong>
  Pay And Benefits
  <br/>
  <br/>
 </strong>
 The pay range for this position is $18.00 - $22.00/hr.
 <br/>
 <br/>
 <strong>
  Requirements
  <br/>
  <br/>
 </strong>
 Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:
 <br/>
 <br/>
 <ul>
  <li>
   Medical, dental &amp; vision
  </li>
  <li>
   Critical Illness, Accident, and Hospital
  </li>
  <li>
   401(k) Retirement Plan &ndash; Pre-tax and Roth post-tax contributions available
  </li>
  <li>
   Life Insurance (Voluntary Life &amp; AD&amp;D for the employee and dependents)
  </li>
  <li>
   Short and long-term disability
  </li>
  <li>
   Health Spending Account (HSA)
  </li>
  <li>
   Transportation benefits
  </li>
  <li>
   Employee Assistance Program
  </li>
  <li>
   Time Off/Leave (PTO, Vacation or Sick Leave)
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Workplace Type
  <br/>
  <br/>
 </strong>
 This is a fully remote position.
 <br/>
 <br/>
 <strong>
  Application Deadline
  <br/>
  <br/>
 </strong>
 This position is anticipated to close on May 20, 2026.
 <br/>
 <br/>
 Diversity, Equity &amp; Inclusion
 <br/>
 <br/>
 At Actalent, Diversity And Inclusion Are a Bridge Towards The Equity And Success Of Our People. DE&amp;I Is Embedded Into Our Culture Through
 <br/>
 <br/>
 <ul>
  <li>
   Hiring diverse talent
  </li>
  <li>
   Maintaining an inclusive environment through persistent self-reflection
  </li>
  <li>
   Building a culture of care, engagement, and recognition with clear outcomes
  </li>
  <li>
   Ensuring growth opportunities for our people
   <br/>
   <br/>
  </li>
 </ul>
 Actalent is an equal opportunity employer.
 <br/>
 <br/>
 <strong>
  About Actalent
  <br/>
  <br/>
 </strong>
 Actalent is a global leader in engineering and sciences services. For more than 40 years, we&rsquo;ve helped visionary companies advance their goals. Headquartered in the United States, our teams span 150 offices across North America, EMEA, and APAC&mdash;with four delivery centers in India led by 1,000+ extraordinary employees who connect their passion with purpose every day.
 <br/>
 <br/>
 Our Bangalore, Hyderabad, Pune, and Chennai delivery centers are hubs of engineering expertise, with core capabilities in mechanical and electrical engineering, systems and software, and manufacturing engineering. Our teams deliver work across multiple industries including transportation, consumer and industrial products, and life sciences. We serve more than 4,500 clients, including many Fortune 500 brands. Learn more about how we can work together at actalentservices.com.
</div>


Pharmacy Technician

Onco360 Oncology Pharmacy

<div>
 <strong>
  Pharmacy Prior Authorization Specialist &ndash; Onco360 Pharmacy
  <br/>
  <br/>
 </strong>
 <em>
  Woodridge, IL
 </em>
 |
 <em>
  Full-Time
 </em>
 |
 <em>
  Starting at $23.00/hr and up
  <br/>
  <br/>
 </em>
 <strong>
  Join a mission-driven team making a difference in the lives of cancer patients.
  <br/>
  <br/>
 </strong>
 Onco360 Pharmacy is seeking a
 <strong>
  Pharmacy Prior Authorization Specialist
 </strong>
 to join our dedicated team in Woodridge, IL. This is a full-time position ideal for candidates local to the area. Remote work possible after initial on-site training.
 <br/>
 <br/>
 <strong>
  Why Join Us?
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   A career with purpose: Help patients access life-saving medications.
  </li>
  <li>
   Supportive culture: We value teamwork, respect, integrity, and passion.
  </li>
  <li>
   Growth opportunities: We invest in your professional and personal development.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Company Benefits
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Medical; Dental; Vision
  </li>
  <li>
   401k with a match
  </li>
  <li>
   Paid Time Off and Paid Holidays
  </li>
  <li>
   Tuition Reimbursement
  </li>
  <li>
   Quarterly Incentive Bonus
  </li>
  <li>
   Paid Volunteer Day
  </li>
  <li>
   Referral Incentive Program
  </li>
  <li>
   Company Paid Life Insurance; and Short/Long-Term Disability
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  What You&rsquo;ll Do
  <br/>
  <br/>
 </strong>
 The Pharmacy Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations from insurance carriers by receiving prescriptions, addressing and rectifying rejected claims and conducting necessary third party authorization requests.
 <br/>
 <br/>
 <strong>
  How You&rsquo;ll Do This
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Manage prior authorization requests and appeals with insurance carriers.
  </li>
  <li>
   Collaborate with physicians, pharmacists, and other departments.
  </li>
  <li>
   Ensure HIPAA compliance while handling sensitive patient information.
  </li>
  <li>
   Maintain accurate documentation of authorization details.
  </li>
  <li>
   Proactively monitor and renew expiring authorizations.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  What You Bring
  <br/>
  <br/>
 </strong>
 <em>
  <strong>
   Required:
   <br/>
   <br/>
  </strong>
 </em>
 <ul>
  <li>
   High School Diploma or GED
  </li>
  <li>
   1+ years of pharmacy or prior authorization experience
  </li>
  <li>
   Registration with Board of Pharmacy (as required by state law)
  </li>
  <li>
   Strong communication, organizational, and customer service skills
  </li>
  <li>
   Self-motivated, organized, detail-oriented, and adaptable to changing priorities
  </li>
  <li>
   Knowledge of pharmacy terminology, pharmacy insurance claims, Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, experience with CoverMyMeds
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Preferred:
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Associate degree or Certified Pharmacy Technician (PTCB)
  </li>
  <li>
   3+ years of experience in pharmacy or prior authorizations
  </li>
  <li>
   Specialty pharmacy experience
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Ready to make a meaningful impact? Apply today and help us better the lives of those battling cancer.
  <br/>
  <br/>
 </strong>
 <strong>
  #Company Values: Teamwork, Respect, Integrity, Passion
  <br/>
  <br/>
 </strong>
 #IH
</div>


Pharmacy Prior Authorization Specialist

Onco360

<div><div><b>Pharmacy Prior Authorization Specialist &ndash; Onco360 Pharmacy</b><br>
<i>Louisville, KY</i> | <i>Full-Time</i> | <i>Starting at $23.00/hr and up</i></div>
<div></div><div><div>Onco360 Pharmacy is seeking a <b>Pharmacy Prior Authorization Specialist</b> to join our dedicated team in Louisville, KY. This is a full-time position ideal for candidates local to the area. Remote work possible after initial on-site training.</div>
<div> </div><p></p><div><div><b>Why Join Us?</b></div>
<ul><li>A career with purpose: Help patients access life-saving medications.</li>
<li>Supportive culture: We value <b>teamwork, respect, integrity, and passion</b>.</li>
<li>Growth opportunities: We invest in your professional and personal development.</li>
</ul></div></div><div><b>Company Benefits</b></div>
<ul><li>Medical; Dental; Vision</li>
<li>401k with a match</li>
<li>Paid Time Off and Paid Holidays</li>
<li>Tuition Reimbursement</li>
<li>Quarterly Incentive Bonus</li>
<li>Paid Volunteer Day</li>
<li>Referral Incentive Program</li>
<li>Company Paid Life Insurance; and Short/Long-Term Disability</li>
</ul><p></p><div><b>What You&rsquo;ll Do</b></div>
<div></div><div>The Pharmacy Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations from insurance carriers by receiving prescriptions, addressing and rectifying rejected claims and conducting necessary third party authorization requests.</div>
<div></div><div><b>How You&rsquo;ll Do This</b></div>
<ul><li>Manage prior authorization requests and appeals with insurance carriers.</li>
<li>Collaborate with physicians, pharmacists, and other departments.</li>
<li>Ensure HIPAA compliance while handling sensitive patient information.</li>
<li>Maintain accurate documentation of authorization details.</li>
<li>Proactively monitor and renew expiring authorizations.</li>
</ul><p></p><div><b>What You Bring</b></div>
<div></div><div><b><i>Required:</i></b></div>
<ul><li>High School Diploma or GED</li>
<li>1+ years of pharmacy or prior authorization experience</li>
<li>Registration with Board of Pharmacy (as required by state law)</li>
<li>Strong communication, organizational, and customer service skills</li>
<li>Self-motivated, organized, detail-oriented, and adaptable to changing priorities</li>
<li>Knowledge of pharmacy terminology, pharmacy insurance claims, Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, experience with CoverMyMeds</li>
</ul><div><b>Preferred:</b></div>
<ul><li>Associate degree or Certified Pharmacy Technician (PTCB)</li>
<li>3+ years of experience in pharmacy or prior authorizations</li>
<li>Specialty pharmacy experience</li>
</ul><p></p><div><b>Ready to make a meaningful impact? Apply today and help us better the lives of those battling cancer.</b></div>
<div></div><div><b>#Company Values: Teamwork, Respect, Integrity, Passion</b></div>
<div>#IH</div></div><div></div>

<div>
 <strong>
  Pharmacy Prior Authorization Specialist &ndash; Onco360 Pharmacy
  <br/>
  <br/>
 </strong>
 <em>
  Houston, TX
 </em>
 |
 <em>
  Full-Time
 </em>
 |
 <em>
  Starting at $23.00/hr and up
  <br/>
  <br/>
 </em>
 <strong>
  Join a mission-driven team making a difference in the lives of cancer patients.
  <br/>
  <br/>
 </strong>
 Onco360 Pharmacy is seeking a
 <strong>
  Pharmacy Prior Authorization Specialist
 </strong>
 to join our dedicated team in Houston, TX. This is a full-time position ideal for candidates local to the area.
 <strong>
  Remote work possible after initial on-site training.
  <br/>
  <br/>
 </strong>
 <strong>
  Why Join Us?
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   A career with purpose: Help patients access life-saving medications.
  </li>
  <li>
   Supportive culture: We value teamwork, respect, integrity, and passion.
  </li>
  <li>
   Growth opportunities: We invest in your professional and personal development.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Company Benefits
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Medical; Dental; Vision
  </li>
  <li>
   401k with a match
  </li>
  <li>
   Paid Time Off and Paid Holidays
  </li>
  <li>
   Tuition Reimbursement
  </li>
  <li>
   Quarterly Incentive Bonus
  </li>
  <li>
   Paid Volunteer Day
  </li>
  <li>
   Referral Incentive Program
  </li>
  <li>
   Company Paid Life Insurance; and Short/Long-Term Disability
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  What You&rsquo;ll Do
  <br/>
  <br/>
 </strong>
 The Pharmacy Prior Authorization Specialist will ensure patients receive the medication that requires pre-authorizations from insurance carriers by receiving prescriptions, addressing and rectifying rejected claims and conducting necessary third party authorization requests.
 <br/>
 <br/>
 <strong>
  How You&rsquo;ll Do This
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Manage prior authorization requests and appeals with insurance carriers.
  </li>
  <li>
   Collaborate with physicians, pharmacists, and other departments.
  </li>
  <li>
   Ensure HIPAA compliance while handling sensitive patient information.
  </li>
  <li>
   Maintain accurate documentation of authorization details.
  </li>
  <li>
   Proactively monitor and renew expiring authorizations.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  What You Bring
  <br/>
  <br/>
 </strong>
 <em>
  <strong>
   Required:
   <br/>
   <br/>
  </strong>
 </em>
 <ul>
  <li>
   High School Diploma or GED
  </li>
  <li>
   1+ years of pharmacy or prior authorization experience
  </li>
  <li>
   Registration with Board of Pharmacy (as required by state law)
  </li>
  <li>
   Strong communication, organizational, and customer service skills
  </li>
  <li>
   Self-motivated, organized, detail-oriented, and adaptable to changing priorities
  </li>
  <li>
   Knowledge of pharmacy terminology, pharmacy insurance claims, Medicare, Medicaid, and commercial insurance, pharmacy test claim and NCPDP claim rejection resolution, coordination of benefits, NDC medication billing, experience with CoverMyMeds
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Preferred:
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Associate degree or Certified Pharmacy Technician (PTCB)
  </li>
  <li>
   3+ years of experience in pharmacy or prior authorizations
  </li>
  <li>
   Specialty pharmacy experience
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Ready to make a meaningful impact? Apply today and help us better the lives of those battling cancer.
  <br/>
  <br/>
 </strong>
 <strong>
  #Company Values: Teamwork, Respect, Integrity, Passion
  <br/>
  <br/>
 </strong>
 #IH
</div>


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