TempleRecruiter Since 2001
the smart solution for Temple jobs

Pharmacy Benefit Coordinator Temple or Austin

Company: Baylor Scott & White Health
Location: Temple
Posted on: January 12, 2021

Job Description:

*JOB SUMMARY* The Pharmacy Benefit Coord serves in a key role in the development, implementation and management of comprehensive and effective pharmacy programs and benefits. Leads clinical and compliance monitoring of all aspects of pharmacy benefit management (PBM) and operational areas, including claim adjudication and benefit analysis, pharmacy benefit implementation and documentation for specific lines of business. Leads workgroups and projects as assigned. *ESSENTIAL FUNCTIONS OF THE ROLE* Acts as a Subject Matter Expert (SME) for specific lines of business as related to pharmacy benefit programs and operations. Responsible for urgent and complex adjudication and processing issues including research, analysis, identification of root cause, impact analysis and corrective action, partnering with vendor through resolution. Conducts moderate to complex data analysis including creating the reports and pulling the data while providing regularly scheduled reporting and communication to management. Responsible for implementing and ensuring accuracy of pharmacy plan designs and clinical programs. Routinely interacts with vendors and internal stakeholders to coordinate benefits, resolve access to care issues, operationalize clinical programs, and ensure compliance with standards defined by the Health Plan and regulatory governing bodies. Responsible for education and training of staff regarding pharmacy benefit requirements, processes and key projects, promoting best practices. Leads implementation testing of new functionality to ensure desired outputs. Prepares test scenarios and executes testing. Assists with development of report mapping and generates required data reports for audits. Responsible for review of standard and ad-hoc reports to confirm compliance with Health Plan, regulatory and accreditation standards, address gaps and ensures sound operations. Assists with preparation for and serves as subject matter expert in audits conducted by regulatory and accreditation bodies. Interprets and accurately applies regulatory requirements that are applicable to the job function. *KEY SUCCESS FACTORS* Certified Pharmarcy Technician (CPHT) preferred. Ability to lead and delegate tasks through other team members. Demonstrated ability to manage multiple priorities and deadlines in a fast-paced environment. Problem-solving, critical thinking skills and attention to detail a must. Well-organized and self-directed individual who is able to work with minimal amount of supervision. Sound technical skills and analytical ability, advanced ability to apply reasoned judgment, and strong operational focus. Advanced proficiency in Microsoft Office and in a variety of industry related software programs. Knowledge of PBM operations, formulary management and utilization management edits preferred. Knowledge of drug nomenclature, basic pharmacology, dosage calculations, units of measure, prescription filing techniques, prescription documentation requirements, pharmacy laws and regulations, basic managed care principles and insurance coverage issues. Knowledge of multiple clinical pharmacy resources. Ability to interact and maintain professional working relationships with internal and external partners to coordinate benefits and services. Demonstrates professional business acumen including attendance, adherence, attitude and behavior. *BENEFITS* Our competitive benefits package includes the following- Immediate eligibility for health and welfare benefits- 401(k) savings plan with dollar-for-dollar match up to 5%- Tuition Reimbursement- PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level *QUALIFICATIONS* - EDUCATION - Bachelors or Equivalent Exp - EXPERIENCE - A minimum of 3 years experience required

Keywords: Baylor Scott & White Health, Temple , Pharmacy Benefit Coordinator Temple or Austin, Other , Temple, Texas

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Other Jobs


Correctional Officer
Description: -No Experience Necessary NEXT CLASS STARTING 02/01/2021Our officers start at 12.00 per hour and enjoy a full benefits package including: ul li Health and dental insurance li Tuition reimbursement (more...)
Company: Management & Training Corporation
Location: San Marcos
Posted on: 01/16/2021

Delivery Driver/Runner
Description: Are you looking for a flexible way to earn extra cash daily, make your own schedule, and provide a great experience to customers, all while
Company: Favor
Location: Pflugerville
Posted on: 01/16/2021

Critical Care Tech ECC Emerg Care
Description: Description Summary: The critical care technician CCT is a certified and/or licensed technician and is part of the Intensive Care Department patient care team who collaboratively works in a complementary (more...)
Company: Christus Health
Location: San Marcos
Posted on: 01/16/2021


Licensed Automotive Inspector
Description: Geared for the Driven Safety is always top of mind for Valvoline Instant Oil ChangeSM VIOC , and we want you to know that we are working hard to protect our team members and our guests with our stay-in-your-car (more...)
Company: Valvoline Instant Oil Change
Location: Pflugerville
Posted on: 01/16/2021

Licensed Automotive Inspector
Description: Geared for the Driven br br Safety is always top of mind for Valvoline Instant Oil ChangeSM VIOC , and we want you to know that we are working hard to protect our team members and our guests with (more...)
Company: Valvoline Instant Oil Change
Location: Pflugerville
Posted on: 01/16/2021

Travel Nurse RN - OR Trauma Surgery
Description: Nationwide Travel Nurse Jobs - Trauma Surgery RN Are you looking for a new nursing job Would you like to spend the season somewhere you've never been Hospitals nationwide are looking for qualified registered (more...)
Company: HealthCare Traveler Jobs
Location: San Marcos
Posted on: 01/16/2021

Travel ICU RN / Crisis COVID-19 - Intensive Care Unit
Description: Intensive Care Unit RN - Nationwide Travel Nurse Assignments Are you looking for a new nursing job Would you like to spend the season somewhere you've never been Hospitals nationwide are looking for (more...)
Company: HealthCare Traveler Jobs
Location: San Marcos
Posted on: 01/16/2021

Appointment Scheduling Entry Level
Description: We are currently seeking work from home customer service, appointment setting, telemarketing and data entry representatives. You're main responsibility is to supply specialized guidance to our current (more...)
Company: Tima
Location: San Marcos
Posted on: 01/16/2021

Runner/Delivery Driver
Description: Are you looking for a flexible way to earn extra cash daily, make your own schedule, and provide a great experience to customers, all while
Company: Favor
Location: Pflugerville
Posted on: 01/16/2021

Travel Nurse RN - OR Trauma Surgery
Description: Nationwide Travel Nurse Jobs - Trauma Surgery RN Are you looking for a new nursing job Would you like to spend the season somewhere you've never been Hospitals nationwide are looking for qualified registered (more...)
Company: HealthCare Traveler Jobs
Location: Pflugerville
Posted on: 01/16/2021

Log In or Create An Account

Get the latest Texas jobs by following @recnetTX on Twitter!

Temple RSS job feeds