Job Discription
Candidates hired for remote positions must reside in Oregon, Washington, Utah, Idaho, Arizona, or Nevada.
Job Title | Pharmacy Benefit Specialist II |
Exemption Status | Non-Exempt |
Department | Pharmacy |
Manager Title | Pharmacy Benefit Operations Supervisor |
Direct Reports | n/a |
Requisition # | 23490 |
Pay and Benefits | Estimated hiring range $68,390 – $82,750, 5% bonus target, full benefits. To learn more about our benefits, please visit |
Job Summary
This position is responsible for working with CareOregon members, their providers, and pharmacies to support the pharmacy benefit and prescription needs under the major medical benefit. This is an advanced level support position, requiring Pharmacy Technician Certification. Core responsibilities include customer service, claims processing, prior authorizations, formulary exceptions, appeals, grievances, and project participation.
Essential Responsibilities
Customer Service and Claims Processing
Data Entry and Clerical Support
Prior Authorizations (PA) and Formulary Exceptions
Appeals and Grievances
Project Coordination
Organizational Responsibilities
Experience and/or Education
Required
Knowledge, Skills and Abilities Required
Knowledge
Skills and Abilities
Working Conditions
Indoor/Office Community Facilities/Security Outdoor Exposure
Member/Patient Facing: No Telephonic In Person
Hazards: May include, but not limited to, physical and ergonomic hazards.
Travel: May include occasional required or optional travel outside of the workplace; the employee’s personal vehicle, local transit or other means of transportation may be used.
#Li-Remote
Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment
Veterans are strongly encouraged to apply.
Equal opportunity employer. This company considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
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We are an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, national origin, disability, veteran status, and other protected characteristics. The EEO is the Law poster is available here.
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