Act as a subject matter expert handling complex pharmacy issues
Respond to escalated calls from members, provider/physician's offices and pharmacies
Make outbound calls and enters pharmacy overrides into systems
Take member/prescriber/pharmacist inquiry calls for benefit questions
Offer options including submission of prior authorization requests
Thoroughly research issues and take appropriate action to resolve them
Assist team members by guiding them to resolutions of complex inquiries
Participate in training of less experienced staff
Act as a liaison between internal departments on data gathering
Present proposed solutions clearly and concisely
Assist with audit preparation and miscellaneous special project work

High School Diploma / GED
2 years of experience
Call center / customer service experience
Experience in healthcare environment (pharmacy operations, managed care, pharmacy hospitals and or pharmacy retail settings)
Pharmacy technician certification preferred.

Senior Pharmacy Resolution Specialist

About this role