Pharmacy Operations Specialist

Job Summary

A company is looking for a Pharmacy Operations Specialist (Remote).

Key Responsibilities

• Process and review pharmacy prior authorization requests while meeting regulatory standards
• Apply clinical and pharmacy policy criteria to authorization and benefit determinations
• Communicate authorization decisions and pharmacy information to members and internal teams

Required Qualifications

• High school diploma or equivalent required; associate or bachelor's degree preferred
• Two or more years of experience in a healthcare or pharmacy-related setting
• Prior exposure to managed care or pharmacy benefits preferred
• Strong customer service background supporting members or providers
• Demonstrated attention to detail and strong data entry skills