Pharmacy Program Specialist II
About the role
Built to Care. Driven to Improve. At Community Health Choice, we’re a nonprofit health plan dedicated to improving the health and well-being of Texans, especially underserved communities. Our employees bring purpose into practice every day through compassion, collaboration, and a commitment to better outcomes.
Responsibilities
- Performs a criteria-based review of pharmacy and medical benefit requests in accordance with established clinical guidelines, plan policies, and prior authorization protocols.
- Contributes to reporting, monitoring delegated PBM functions, and promoting member adherence.
- Delivers a high level of customer service.
Requirements
- Bachelor's degree in the healthcare field, or in business administration
- Actively registered with the Texas State Board of Pharmacy as a certified pharmacy technician
- 3+ years of experience with a Health Plan or PBM in related functions
- Strong experience with prior drug authorization process in a Health Plan or PBM
- Maintains Microsoft Office (Word, Excel, Outlook, PowerPoint); Visio preferred
- Strong attention to detail, problem-solving, and interpersonal skills
Qualifications
- Bachelor's degree in the healthcare field, or in business administration
- Actively registered with the Texas State Board of Pharmacy as a certified pharmacy technician
- 3+ years of experience with a Health Plan or PBM in related functions
- Strong experience with prior drug authorization process in a Health Plan or PBM
- Maintains Microsoft Office (Word, Excel, Outlook, PowerPoint); Visio preferred
- Strong attention to detail, problem-solving, and interpersonal skills
Skills
- Strong understanding of pharmacy and medical benefit drug coverage
- Adherence to regulatory timelines
- Microsoft Office (Word, Excel, Outlook, PowerPoint); Visio preferred
- Attention to detail, problem-solving, and interpersonal skills
Benefits
Community employees benefits are provided by Harris Health. These benefits are designed to provide you with flexibility and choices in meeting your specific needs.
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