Cleveland Clinic Pharmacy Benefits Coordinator in Independence, Ohio
Job ID: 138638
Under the direction of the Director of Pharmacy Management, Employee Health Plan, assists in the operation of the prescription drug program.
Responds to physician and member inquires relating to the prescription drug program.
Enters all benefit override requests into an internal database.
Utilizes current internal database for pharmacy benefit overrides.
Generates appropriate letters and reports and other requests.
Places manual benefit overrides into external vendor's (PBM) computer system.
Compiles data and formats this information into the appropriate medium.
Interfaces with external vendor (PBM) to ensure proper benefit coding and resolve escalated issues.
Ensures proper prescription drug benefit coding and develops solutions to problems that cannot be resolved internally.
Assists the outpatient pharmacy and human resources departments with benefit coverage questions and other copay related issues.
Assists with the implementation and management of pharmacy disease management programs.
Analyzes and processes other reports to send out mailings or place phone calls to the appropriate members regarding benefit changes.
Other duties as assigned.
- High School Diploma or GED; Knowledge of pharmacy terminology.
- Certified Pharmacy Technician (CPhT) verified through the Pharmacy Technician Certification Board (PTCB).
Complexity of Work:
Within scope of job, requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.
Must be able to work in a stressful environment.
- Minimum of six months retail pharmacy experience or Pharmacy Technician certification.
Requires frequent computer entry, sitting, standing and walking.
Normal or corrected vision, hearing and speech.
Personal Protective Equipment :
- Follows standard precautions using personal protective equipment as required.
Cleveland Clinic is pleased to be an equal employment/affirmative action employer: Women/Minorities/Veterans/Individuals with Disabilities.
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