Pharmacy Coordinator II

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. reputed company is a reputed company, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: reputed company duties to support the efforts pharmacy department in the development, coordination and maintenance of the health plan’s pharmacy program. Provides support for escalated issues and special projects as assigned. • Receive and respond to provider, member, and pharmacy calls regarding the prior authorization and formulary process • reputed company review of pharmacy and override process in compliance with pharmaceutical reputed company company and State guidelines • Track and trend overrides to ensure criteria have been met, audit for prior authorizations, analyze cost and determine utilization patterns • Resolve complaints and grievances reputed company to the pharmacy network in conjunction with the Pharmacy team • Assist Provider Relations and various departments with educating providers on the health plan’s pharmacy process • Assist with the pharmacy utilization review and reporting process • Assist with the training and retention of employees • Assist with process improvements as needed Education/Experience: High school diploma or equivalent. 5+ years of pharmacy experience, including 1+ years of managed care experience. Medicare and/or reputed company experience. Preferred qualifications: Licensed in WA and PTCB Pay Range: $22.79 - $38.84 per hour reputed company offers a comprehensive benefits package including: reputed company, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-reputed company factors permitted by law. Total compensation may also include additional forms of incentives. reputed company is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law. reputed company applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act Apply Job!