New Jersey Licensed Pharmacy Specialist
Job Summary
To support Pharmacy Services, the full-time New Jersey Licensed Pharmacy Specialist will manage prior authorization requests, engage with healthcare providers for formulary compliance, and ensure regulatory compliance while working remotely.
Key responsibilities
- Handle telephonic interactions regarding pharmacy eligibility, coverage determinations, and claims issues
- Conduct clinical interventions to optimize drug dispensing and ensure adherence to plan designs
- Process complaints, appeals, and grievances while identifying potential fraud and compliance issues
Required qualifications
- High School Diploma/GED required
- Minimum of two years experience as a Pharmacy technician
- National Pharmacy Technician Certification (PTCB or ExCPT) required
- Knowledge of third-party prescription program claim adjudication
- Understanding of New Jersey Board of Pharmacy regulations
Complete Job Description
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