Pharmacy Member Specialist
Gravie
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See open jobs at Gravie.See open jobs similar to "Pharmacy Member Specialist" AXA Venture Partners.Minneapolis, MN, USA
Posted on Aug 20, 2024
Hi, we’re Gravie. Our mission is to improve the way people purchase and access healthcare through innovative, consumer-centric health benefit solutions that people can actually use. Our industry-changing products and services are developed and delivered by a diverse group of unique people. We encourage you to be your authentic self - we like you that way.
We are seeking a dedicated and detail-oriented Pharmacy Member Specialist to join our growing Pharmacy Operations team. This role is crucial in ensuring that our members receive optimal support for their medication needs. The ideal candidate will have a deep understanding of pharmacy benefit management and a commitment to providing exceptional service to our members.
You Will:
· Provide support to Gravie’s Clinical team in relation to pharmacy needs including Home Infusion, Musculoskeletal program support, specialty savings programs, and more.
· Help facilitate both provider and member outreach campaigns.
· Address inquiries related to coverage, medication management, prior authorizations, specialty savings programs, pharmacy networks, and more.
· Investigate and resolve pharmacy claims issues by working with the claims team and Gravie’s PBM to ensure accurate processing and payments.
· Provide education to members about their pharmacy benefits and covered formulary options, as well as cost saving opportunities and medication adherence strategies.
· Identify areas for process improvement and contribute to the development of the department to enhance pharmacy benefit services.
· Support internal teams, including operations, sales, brokers, account management, customer care, clinical operations with questions and issues related to pharmacy care to deliver a seamless member experience.
· Other duties as assigned.
You Bring:
· 3 + years of Retail, Mail Order, or specialty pharmacy experience, preferably with patient escalation issues, or equivalent experience in a similar setting.
· Experience working with cross functional teams to understand business strategy and implement defined processes.
· Fact-based problem solver with the ability to evaluate alternative courses of action and make sound engagement decisions.
· Ability to multitask and deal with ambiguity.
· Relentless focus on the member experience.
Extra Credit:
· Certified Pharmacy Tech
· Previous Health Insurance and/or PBM experience, specifically with client and/or customer care.
· Prior knowledge of clinical programs as they relate to pharmacy.
Competitive pay is standard. Our unique benefits program is the gravy, i.e., the special sauce that sets our compensation package apart. In addition to standard benefits, Gravie’s package includes alternative medicine coverage, flexible PTO, up to 16 weeks paid parental leave, paid holidays, cell phone reimbursement, education reimbursement, and 1 week of paid paw-ternity leave just to name a few.
This job is no longer accepting applications
See open jobs at Gravie.See open jobs similar to "Pharmacy Member Specialist" AXA Venture Partners.