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Pharmacy Services 2 - 95576

Rancho Cordova, CA 95670

Employment Type: Contract Job Number: 9020627 Pay Rate: Pay Rate: $25.36 per hour

Job Description


Pharmacy Services Specialist




Job Summary


Coordinate, assist, and support the implementation of procedures and guidelines for the outpatient pharmacy benefit drug prior authorization program. Evaluate prior authorization requests, provide pharmacy benefit information to internal partners, and communicate coverage and formulary details to external and internal stakeholders.



Responsibilities


  • Coordinate, assist in, and support implementation of procedures and guidelines for the drug prior authorization program for the outpatient pharmacy benefit.

  • Evaluate prior authorization requests based on medication policy and operational principles.

  • Provide drug usage history and other pertinent pharmacy benefit related information to internal business partners for case-specific reviews and drug evaluations.

  • Communicate with physicians, physician office staff, pharmacies, and internal business partners to ensure accurate and efficient resolution of pharmacy benefit inquiries.

  • Clearly communicate formulary alternatives and prior authorization criteria, and explain pharmacy benefit coverage when required.




Requirements


  • High School diploma or GED.

  • Current California Pharmacy Technician License.

  • Minimum of 2 years of pharmacy experience.

  • Strong phone and verbal communication skills with active listening abilities.

  • Basic computer skills, including use of Outlook and Teams.

  • Ability to multitask, set priorities, and manage time effectively.

  • No current California Pharmacy Technician License or less than 2 years of pharmacy experience will not be considered.




Skills


  • Pharmacy operations and prior authorization processing.

  • Customer service and call center communication.

  • Active listening and clear verbal communication.

  • Time management and prioritization.

  • Basic proficiency with standard office and communication software.

  • Collaboration with cross-functional internal teams.




Summary Qualification


  • High School/GED with an active California Pharmacy Technician License.

  • At least 2 years of pharmacy experience, preferably in a health insurance or managed care environment.

  • Previous call center or high-volume customer service experience is preferred.

  • Demonstrated ability to handle multiple tasks while maintaining accuracy and service quality.

  • Proficient in using basic computer applications, including email and collaboration tools.



Wollborg Michelson Recruiting is an Equal Opportunity Employer and prohibits discrimination of any kind. We ensure job offers are made based of one s employment experience, skills, and qualifications, regardless of race, gender, ethnic origin, or any other classification protected by law. All applicants must furnish proper identification to prove their legal right to work in the US upon a job offer. We participate in E-Verify to confirm one s right to work in the US. Wollborg Michelson Recruiting does not provide sponsorship for an employment-based visa status.
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About Rancho Cordova, CA

Discover exciting job opportunities in the vibrant area surrounding Rancho Cordova, California! Join us in this flourishing community, nestled in the heart of Sacramento County. Rancho Cordova boasts a thriving job market, offering immense growth potential for career seekers. With its proximity to the American River, Folsom Lake, and the beautiful Sierra Nevada mountains, outdoor enthusiasts will find endless opportunities for adventure. Home to landmarks like the Mather Field Aviation Museum and the American River Parkway, this area perfectly blends history and natural beauty. Indulge in the region's diverse cuisine, catch a show at the Sacramento Theatre Company, or cheer on the NBA's Sacramento Kings at the Golden 1 Center – there's something for everyone here. Begin your career journey in Rancho Cordova, where work-life balance meets endless possibilities!