Job Description

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Anthem, Inc., its a powerful combination, and the foundation upon which were creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health care companies and a Fortune Top 50 Company.

Pharmacy Services Coordinator l or Sr (PS47332)

***This position can be filled at the Level l or Sr based on skills and experience.***

Location: This opportunity is available within 50 miles of one of our IngenioRx locations in the following locations. (During the office closures due to COVID this position will work at home).
Atlanta, GA
Chicago, IL
Las Vegas, NV
Louisville, KY
Mason, OH
Minneapolis, MN
Morristown, NJ
St Louis, MO
Virginia Beach, VA
Wallingford, CT

The Pharmacy Services Coordinator l is responsible for being the primary contact and liaison for and between the company's medical partners and the pharmacy vendor for implementing and de-implementing client Rx benefits.

The Pharmacy Services Coordinator Sr. is responsible for overseeing the flow of operational functions & activities assisting in the development & implementation of complex pharmacy benefit products.
Primary duties of both roles may include, but are not limited to:
Understands the intricacies of prescription drug benefits and how they adjudicate.
Understands and interprets client requests for new benefit designs.
Coordinates, conducts and/or supports internal and external client meetings or training sessions as needed.
Works with multiple departments and sources in order to accommodate the needs of our clients; this includes claim processing, customer service, & medical account management.
Oversees benefit set up process to ensure pharmacy product changes occur with minimal disruption.
Develops, reviews, and researches capabilities of pharmacy system to accommodate drug benefit design requested by clients or suggested by medical teams.

In addition, the Pharmacy Services Coordinator l duties include:
Researches and interprets claims issues while ensuring good, accurate and timely customer service for our Anthem pharmacy clients.
This includes attendance and support for processes to review new plan design requests, i.e. Customer Exception Process and National Accounts Approval Process, and collaborating with Product development, Proposal Development, Customer Exception and Sales Departments.
Create or coordinate the delivery of standard and custom reports for internal and external clients, such as claims, drug utilization and impact reports to our clients in compliance with performance guarantees and client requests.

Qualifications

Requirements

The Pharmacy Services Coordinator l or Sr requires a BA/BS degree; 5 years of customer service, claims, and/or membership experience in healthcare; 3 years related pharmacy experience with working knowledge of pharmacy benefit management industry; or any equivalent combination of education and experience, which would provide an equivalent background.

Additionally, the Pharmacy Services Coordinator Sr requires 1-3 years of Pharmacy Services Coord experience.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) + match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. An Equal Opportunity Employer/Disability/Veteran.

Anthem, Inc. is ranked as one of Americas Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.