Pharmacy Benefits Specialist - Rochester Hills - Full Time/Days

Henry Ford Hospital Rochester Hills , MI 48309

Posted 2 months ago

GENERAL SUMMARY:

The Pharmacy Benefits Specialist is responsible for handling drug claim adjudication issues, prescription prior authorization, and pharmacy benefit inquiries from members/patients, physicians, pharmacies, and other internal and external individuals. Is a subject matter expert in the resolution of pharmacy benefit coverage issues and coordinating prior authorization and exception processes.

EDUCATION & EXPERIENCE:

  • Requires a High school diploma or G.E.D. Associates degree preferred.

  • Requires State of Michigan Pharmacy Technician License.

  • Requires a minimum of two years of previous pharmacy technician experience.

  • Previous experience as a specialty pharmacy technician preferred.

  • Knowledge in the specialty disease states (Oncology, Autoimmune Disease, Neurology, Hepatology, other miscellaneous Specialty Diseases) preferred.

  • Knowledge of benefits investigation, prior authorization support, and patient financial assistance work preferred.

  • Requires a strong understanding and knowledge of medical/clinical and pharmacy terminology. EMR systems (Epic or Cerner), dispensing systems (McKesson Enterprise, QS1, or RX30) and specialty pharmacy patient management programs (Asembia-1, Therigy, or Dromos PTM) experience is preferred.

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Pharmacy Benefits Specialist - Rochester Hills - Full Time/Days

Henry Ford Hospital