Hiring Now: Pharmacy Operations Specialist (CPhT) Remote
Position at a Glance:Position: Pharmacy Operations Specialist (cpht) RemoteLocation: RemoteStart Date: Immediate openings availableCompany: WorkwarpCompensation: a competitive salary  Molina Healthcare is hiring for a remote Pharmacy Operations Specialist
This role can be worked remotely anywhere within the US...
This role will be the primary contact for affiliated health plans, Pharmacy Benefit Managers and Corporate shared services with respect to pharmacy operations. This role is very dynamic, and the department is fast paced, requiring attention to detail, analysis and excellent communication.
HIGHLY QUALIFIED APPLICANTS WILL HAVE THE FOLLOWING:
 Pharmacy Technician certification (National)
 Excellent observation and communication skills
 Comfortable monitoring pharmacy claims and reporting to the Healthplan
 Solid understanding of how pharmacy benefits work.
KNOWLEDGE/SKILLS/ABILITIES
 Support Medicaid, and Marketplace lines of business
 Surveillance and Oversight of delegated functions:
 Analyze and interpret data to identify erroneous execution of the pharmacy benefit by the PBM
 Review the daily inventory of \"outliers\" and remediate as required
 Review protocols for accuracy and compliance. Includes: Claims, Network, Digital, etc.
 Support internal/external audits
 Monitoring state and federal landscape for new opportunities
 Collaborate with cross functional partners to implement new products and services, as well as support the maintenance of existing business
 Develop and maintain requirements, user stories, test scenarios and test cases
 Support testing execution and defect management
 Review and interpret member's eligibility, claim history, and pharmacy benefit information using the PBM claims software to provide information to both internal and external clients
 Serve as a PBM liaison and other internal teams for real-time support on pharmacy benefit interpretation or issues
 Identify and assist to remediate gaps and/or deficiencies in current processes, tools, reports and dashboards
 Develop and maintain job aids, policies and process documents
 Other responsibilities as required.
JOB QUALIFICATIONS
Required Education: High School Diploma
Preferred Education: Bachelor's degree
Required Experience
 Must have strong data analysis skills and attention to detail
 3-5 years' experience with pharmacy benefit management
 Strong organizational, problem solving, communication, and interpersonal skills
 Excellent written and oral communication skills required
 Must be able to multitask and be results oriented
 3-5 years' experience in a Microsoft Windows environment, including Excel and Access
Preferred Experience
 3-5 years' experience in a managed care of PBM environment
 2+ years of Managed Medicaid or Health Exchanges.
Preferred License, Certification, Association: National Certified Pharmacy Technician (CPhT) certification, preferred
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Key Words: Pharmacy Technician, Pharm Tech, Tech, National Certification, State License, Certification, Claims, Pharmacy Claims, Pharmacy, PBM, National Certified Pharmacy Technician (CPhT) certification, Medicaid, Medicare, Managed Care, MCO, Exchange, PBM, Pharmacy Benefit Management Apply Job! Don't Hesitate, Apply!Don't worry if you don't meet every single requirement. We value a great attitude and a willingness to learn above all. Submit your application today!
Apply Now
This role can be worked remotely anywhere within the US...
This role will be the primary contact for affiliated health plans, Pharmacy Benefit Managers and Corporate shared services with respect to pharmacy operations. This role is very dynamic, and the department is fast paced, requiring attention to detail, analysis and excellent communication.
HIGHLY QUALIFIED APPLICANTS WILL HAVE THE FOLLOWING:
 Pharmacy Technician certification (National)
 Excellent observation and communication skills
 Comfortable monitoring pharmacy claims and reporting to the Healthplan
 Solid understanding of how pharmacy benefits work.
KNOWLEDGE/SKILLS/ABILITIES
 Support Medicaid, and Marketplace lines of business
 Surveillance and Oversight of delegated functions:
 Analyze and interpret data to identify erroneous execution of the pharmacy benefit by the PBM
 Review the daily inventory of \"outliers\" and remediate as required
 Review protocols for accuracy and compliance. Includes: Claims, Network, Digital, etc.
 Support internal/external audits
 Monitoring state and federal landscape for new opportunities
 Collaborate with cross functional partners to implement new products and services, as well as support the maintenance of existing business
 Develop and maintain requirements, user stories, test scenarios and test cases
 Support testing execution and defect management
 Review and interpret member's eligibility, claim history, and pharmacy benefit information using the PBM claims software to provide information to both internal and external clients
 Serve as a PBM liaison and other internal teams for real-time support on pharmacy benefit interpretation or issues
 Identify and assist to remediate gaps and/or deficiencies in current processes, tools, reports and dashboards
 Develop and maintain job aids, policies and process documents
 Other responsibilities as required.
JOB QUALIFICATIONS
Required Education: High School Diploma
Preferred Education: Bachelor's degree
Required Experience
 Must have strong data analysis skills and attention to detail
 3-5 years' experience with pharmacy benefit management
 Strong organizational, problem solving, communication, and interpersonal skills
 Excellent written and oral communication skills required
 Must be able to multitask and be results oriented
 3-5 years' experience in a Microsoft Windows environment, including Excel and Access
Preferred Experience
 3-5 years' experience in a managed care of PBM environment
 2+ years of Managed Medicaid or Health Exchanges.
Preferred License, Certification, Association: National Certified Pharmacy Technician (CPhT) certification, preferred
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Key Words: Pharmacy Technician, Pharm Tech, Tech, National Certification, State License, Certification, Claims, Pharmacy Claims, Pharmacy, PBM, National Certified Pharmacy Technician (CPhT) certification, Medicaid, Medicare, Managed Care, MCO, Exchange, PBM, Pharmacy Benefit Management Apply Job! Don't Hesitate, Apply!Don't worry if you don't meet every single requirement. We value a great attitude and a willingness to learn above all. Submit your application today!
Apply Now