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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.

Responsibilities :

  • 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.

Education:

  • High School Diploma or GED; Knowledge of pharmacy terminology.

Certifications :

  • 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.

Work Experience:

  • Minimum of six months retail pharmacy experience or Pharmacy Technician certification.

Physical Requirements:

  • 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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