[Hiring] Pharmacy Benefit Specialist II @CareOregon

Role Description

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. Core responsibilities include:

• Customer service
• Claims processing
• Prior authorizations
• Formulary exceptions
• Appeals
• Grievances
• Project participation

This is a M-F position.

Estimated Hiring Range: $25.92 - $31.68

Bonus Target: Bonus - SIP Target, 5% Annual

Current CareOregon Employees: Please use the internal Workday site to submit an application for this job.

Qualifications

• Minimum 2 years work experience on a pharmacy team (i.e., retail, long-term care, or hospital) or 2 years’ experience in a health insurance plan
• Minimum 1 year experience with managed care and/or pharmacy benefit management
• Pharmacy Technician Certification (CPhT) - Preferred
• Pharmacy Technician experience - Preferred
• Pharmacy related outbound calls experience - Preferred

Requirements

• Advanced knowledge of medical and pharmaceutical terminology
• Substantial understanding of managed care, Medicare, and Oregon Health Plan concepts
• Proficient with Microsoft Office Products and general computer literacy
• Ability to learn and effectively navigate CareOregon and PBM software programs necessary to perform job responsibilities
• Ability to follow and provide input into policies and procedures in performing job responsibilities
• Advanced listening, verbal, and written communication skills
• Ability to exercise professionalism
• Proficient ability to network and utilize internal and external resources
• Ability to focus on and comprehend information
• Ability to learn new skills and abilities
• Ability to assess a situation and seek or determine appropriate resolution
• Ability to accept managerial direction and feedback
• Ability to tolerate and manage stress
• Results and service oriented
• Ability to be flexible and adaptable
• Ability to organize, plan, and prioritize daily workflow and projects within time constraints
• Ability to work in an environment with diverse individuals and groups
• Ability to work independently with minimal supervision
• Ability to learn, focus, understand, and evaluate information and determine appropriate actions
• Ability to accept direction and feedback, as well as tolerate and manage stress
• Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day
• Ability to hear and speak clearly for at least 3-6 hours/day

Benefits

• Competitive pay
• Bonus opportunity
• Comprehensive benefits package including:
• Medical, dental, vision, life, AD&D, and disability insurance
• Health savings account
• Flexible spending account(s)
• Lifestyle spending account
• Employee assistance program
• Wellness program
• Discounts
• Multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.)
• Strong retirement plan with employer contributions
• PTO and Paid State Sick Time based on hours worked/scheduled hours
• Paid holidays, volunteer time, jury duty, bereavement leave, and more, depending on eligibility
• 401(k) contributions for non-benefits eligible employees