Pharmacy Benefits Coordinator

                    

At Cleveland Clinic Health System, we believe in a better future for healthcare. And each of us is responsible for honoring our commitment to excellence, pushing the boundaries and transforming the patient experience, every day.

                        

We all have the power to help, heal and change lives — beginning with our own. That’s the power of the Cleveland Clinic Health System team, and The Power of Every One.

                                    

Job Title

Pharmacy Benefits Coordinator

                        

Location

Cleveland

                    

Facility

Remote Location

                     

Department

Clinical Integration-EHP-Pharmacy

                      

Job Code

C15025

                     

Shift

Days

                       

Schedule

9:30am-6:00pm

                       

Job Summary

                         

Job Details

Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will receive endless support and appreciation and build a rewarding career with one of the most respected healthcare organizations in the world.   

As a Pharmacy Benefits Coordinator, you will support the administration of the prescription drug plan for Cleveland Clinic’s Employee Health Plan (EHP). Under the direction of the Director of Pharmacy Care, Employee Health Plan, you will assist in the operation of the prescription drug program, address queries and issues, educate members, providers, and pharmacies within the organization. This team is dedicated to ensuring that caregivers and their dependents receive high-quality, evidence-based healthcare focused on both prevention and treatment at a sustainable cost.

A caregiver in this role works days from 9:30 a.m. – 6:00 p.m.

A caregiver who excels in this role will:

• Respond to physician and member inquires relating to the prescription drug program.

• Enter all benefit override requests into an internal database.

• Utilize current internal database for pharmacy benefit overrides.

• Generate appropriate letters and report and other requests.

• Place manual benefit overrides into external vendor's (PBM) computer system.

• Comply data and formats this information into the appropriate medium.

• Interface with external vendor (PBM) to ensure proper benefit coding and resolve escalated issues.

• Ensure proper prescription drug benefit coding and develops solutions to problems that cannot be resolved internally.

• Assist the outpatient pharmacy and human resources departments with benefit coverage questions and other copay related issues.

• Assist with the implementation and management of pharmacy disease management programs.

• Analyze and process other reports to send out mailings or place phone calls to the appropriate members regarding benefit changes.

Minimum qualifications for the ideal future caregiver include:   

• High School Diploma or GED  

• Knowledge of pharmacy terminology

• Certified Pharmacy Technician (CPhT) verified through the Pharmacy Technician Certification Board (PTCB)

• Minimum of six months retail pharmacy experience or Pharmacy Technician certification

Preferred qualifications for the ideal future caregiver include:  

• Prior authorization experience

Our caregivers continue to create the best outcomes for our patients across each of our facilities. Click the link and see how we’re dedicated to providing what matters most to you: https://jobs.clevelandclinic.org/benefits-2/

Physical Requirements:

• Requires frequent computer entry, sitting, standing and walking.

• Normal or corrected vision, hearing and speech.

Personal Protective Equipment:

• Follows standard precautions using personal protective equipment as required.

                       

The policy of Cleveland Clinic Health System and its system hospitals (Cleveland Clinic Health System) is to provide equal opportunity to all of our caregivers and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. All offers of employment are follwed by testing for cont