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Company | Elevance Health |
Address | Winston-Salem, NC, United States |
Employment type | FULL_TIME |
Salary | |
Category | Hospitals and Health Care |
Expires | 2023-08-29 |
Posted at | 8 months ago |
- Type: Full time
- Job Family: Medical and Clinical
- Date Posted:Jun 22, 2023
- Req #: JR77797
- Nevada, Henderson
- Missouri, St Louis
- North Carolina, Greenville
- Virginia, Norfolk
- North Carolina, Winston
- Nevada, Las Vegas
- Ohio, Mason
- Ohio, Cincinnati
- Virginia, Virginia Beach
- Missouri, St. Louis
- Provides resolution to grievances and appeals issues.
- Generates reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports.
- Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits.
- Verifies member information and inputs data for the pharmacists.
- Processes prior authorization requests from physicians' offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations.
- Maintains record keeping of prior authorizations, rebates, and monthly reports.
- Educates members on pharmacy-based rules related to prescriptions and medication resources or assistance programs.
- Current State Pharmacy Tech. Certification or National Certification based on applicable state(s) required.
- Minimum of 1 year of pharmacy experience; or any combination of education and experience, which would provide an equivalent background.
- Requires H.S. diploma or equivalent.
- For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
- The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
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