Pharmacy Operations Representative CPhT - Albuquerque, NM
About the position
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Located in Albuquerque, NM, and as a valued member of our Pharmacy Medicare team, you will be responsible for providing assistance to the customer service team, pharmacy coordinators, pharmacists, and members in resolution of various pharmacy claims, pricing, and coding issues. This role involves working with internal departments and external vendors to evaluate and resolve pharmacy-related issues. This position will provide a flexible schedule requiring 3 days working in the office and allows up to 2 days working from home in Albuquerque, NM. Core business hours are from 8:00 am to 5:00 pm, Monday through Friday. Importantly, there are no weekend or evening shifts required, allowing for a balanced work-life environment.
Responsibilities
Provide assistance to the customer service team, pharmacy coordinators, pharmacists, and members in resolving pharmacy claims, pricing, and coding issues.
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Work with internal departments and external vendors to evaluate and resolve pharmacy-related issues.
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Collaborate with internal stakeholders such as Customer Service Team, PBM/Pharmacy, Providers, and members to resolve pharmacy-related gaps in care, coverage, and claims submission issues.
Requirements
Must have a valid Certified Pharmacy Technician (CPhT) certification.
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Bachelor's degree in Business or a related healthcare field OR 4 years of work experience in a pharmacy/healthcare/managed care industry.
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Strong verbal and written communication skills.
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Proficiency in MS Office products; Word, Excel, Access, and database software.
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Drug information skills are required.
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Ability to handle multiple tasks with strong organizational skills.
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Experience in managed care customer service.
Nice-to-haves
Retail / Hospital / Specialty Pharmacy, Pharmacy Benefits Manager, MCO, Health Plan pharmacy customer service experience.
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Knowledge or experience with Medicare / STARS, Facets.
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Inquisitive, continuous learning, and critical thinking skills for understanding regulations and benefits.
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Ability to complete departmental projects effectively.
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Experience in outbound telephone support to include members, providers, pharmacies, and PBM/vendor, program/campaign outreach.
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Support through written and digital channels.
Benefits
Professional development opportunities.
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Flexible work schedule with a hybrid model (3 days in office, 2 days remote).
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