Prescription (RX) Vendor Coordinator

Position Location: 100% Remote

About the role

The Prescription (RX) Drug Benefit Coordinator is the subject-matter expert regarding pharmacy-related questions and concerns for the i360 organization and our vendor partners. This includes responding to general inquiries, addressing urgent member issues, implementing new procedures to accommodate changes in the healthcare industry, and working closely with other internal teams to provide pharmacy support.

Responsibilities

• Respond to client, pharmacy, or customer requests in a timely manner.
• Act as a point of contact with the Prescription Benefit Manager (PBM) vendors.
• Accurately implement new Plan set-up and Plan Benefit changes to PBM vendor.
• Review and maintain plan parameters for prescription plans.
• Audit plan set up/changes for accuracy.
• Coordinate eligibility with the PBM.
• Review and approve client ID cards and plan docs to ensure accuracy on behalf of Rx Services.
• Run requested reports for i360 and its clients; customize per client requests.
• Act as a role model in demonstrating the core values in customer service delivery.
• Resolve any HelpDesk tickets or Client Change Requests assigned to the Rx Services queue.
• Respond quickly to any urgent eligibility, claim, or accumulator requests.
• Coordinate with internal IT teams to address and resolve any required pharmacy file transmission issues with clients.
• Coordinate with internal teams and vendor partners to address and resolve member issues including eligibility and drug coverage.
• Appropriately escalate difficult issues up the chain of command.
• Train new employees and cross-departmentally as assigned.
• Explain and demonstrate duties and proper procedures in performing duties.
• Serve on committees, work groups, and/or process improvement teams, as assigned, to assist in improving quality/customer satisfaction.
• Collaborate with others and cross-departmentally to improve or streamline procedures.
• Develop new or improve current internal processes to improve quality.
• Recognize and alert appropriate supervisor of trends within their scope of responsibility that fall outside of quality parameters.
• Perform self-quality monitoring to develop and execute plans to meet established goals.
• Provide ongoing feedback to help optimize quality performance.

Requirements

• Associates degree or equivalent experience
• Two years of experience in a pharmacy or medical setting

Preferred Qualifications

• Two years of experience in a pharmacy or medical setting

Skills

• Remote work capabilities
• Proficient mathematical, 10-key, and typing skills
• Working knowledge of computers and software including but not limited to Microsoft Office products
• Demonstrated organizational skills, problem-solving, analytical skills, and detail-oriented
• Demonstrated ability to remain neutral and maintain confidentiality
• Strong written and oral communication skills
• Demonstrated ability to work independently, prioritize workloads, multi-task, and manage priorities to meet deadlines

Benefits

• Multiple Health Plan Options
• Company paid employee premiums for disability and life insurance
• Parental Leave Policy
• 20 days PTO to start / 10 Paid Holidays
• Tuition reimbursement
• 401k Company contribution
• Professional development initiatives / continuous learning opportunities
• Opportunities to participate in and support the company's diversity and inclusion initiatives