Pharmacy Services Coordinator (64334) (Mason, OH) (Future Telecommuting)
WellPoint - United States

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WellPoint is one of the nations leading health benefits insurers and a Fortune Top 50 company. At WellPoint, we are dedicated to improving the lives of the people we serve and the health of our communities. WellPoint strives to simplify the connection between health, care, and value for our customers.

Bring your expertise to our innovative, achievement-driven culture, and you will discover lasting rewards and the opportunity to take your career further than you can imagine.

Pharmacy Services Coordinator

Responsible for being the primary contact and liaison for and between WellPoint, Inc. medical partners and the pharmacy vendor for implementing and de-implementing client Rx benefits. Primary duties may include, but are not limited to:

Researches and interprets claims issues while ensuring good, accurate and timely customer service for our Anthem pharmacy clients.

Understands the intricacies of prescription drug benefits and how they adjudicate.

Understands and interprets client requests for new benefit designs.

Coordinates, conducts and/or supports internal and external client meetings or training sessions as needed.

Works with multiple departments and sources in order to accommodate the needs of our clients; this includes claim processing, customer service, & medical account management.

Oversees benefit set up process to ensure pharmacy product changes occur with minimal disruption.

Develops, reviews, and researches capabilities of pharmacy system to accommodate drug benefit design requested by clients or suggested by medical teams. This includes attendance and support for processes to review new plan design requests, i.e. Customer Exception Process and Client Intake Process, and collaborating with Product development, Proposal Development, Customer Exception and Sales Departments.

Create or coordinate the delivery of standard and custom reports for internal and external clients, such as claims, drug utilization and impact reports to our clients in compliance with performance guarantees and client requests.

WellPoint is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine, one of the 100 Best Places to Work by Working Mother magazine, and is a 2011 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at www.wellpoint.com/careers . EOE

Job Qualifications

Requires a BA/BS degree; 3 years of claims/pharmacy benefit design; 3 years related pharmacy experience with working knowledge of pharmacy benefit management industry; or any equivalent combination of education and experience, which would provide an equivalent background.

Once an offer is accepted, all external applicants are subject to a background investigation
and if appropriate, drug testing. Offers of employment shall be contingent upon
passing both the background investigation and drug testing (if required).

  • Current WellPoint associates: All referrals must be submitted through the formal
associate referral process on WorkNet. Official guidelines for the associate referral
program can be found in My HR.

  • WARNING: Please beware of phishing scams. Our company will never ask
you for bank account information when you are applying for a job.

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WellPoint, Inc. (WellPoint) is a health benefits company serving 35 million medical members, as of December 31, 2008. The Company is an...