Pharmacy Coordinator

Your Future Evolves Here

Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.

Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business.

Join Evolent for the mission. Stay for the culture.

What You’ll Be Doing:

The Evolent pharmacy team is looking for a highly motivated and energetic Pharmacy Coordinator to join the Pharmacy Services team.  We are looking for team members that possess high-energy, a strong work ethic, integrity, who are kind and empathetic, have a sense of humor, and who enjoy working for a collaborative, team-oriented system.  

This position has primary responsibilities to the clinical pharmacy services team and may have other responsibilities supporting the managed care operations team as outlined below in the Responsibilities.   This position requires someone who is highly organized, detail-oriented, personable and able to adapt to a dynamic environment. 

What You Will Be Doing:

• Care Management Collaboration (Clinical Pharmacy Services) Support Medication Therapy Management (MTM) and pharmacy outreach programs (e.g., refill reminders and adherence calls) through telephonic patient outreach, communication with physician offices and accurate documentation processes 

• Support the scheduling and delivery of pharmacist-led consultations and follow-up of patients with complex medical conditions 

• Provide assistance to clinical pharmacy programs including collection of medication history data, drug information research, pharmacy care plan initiation and clinical guideline management under the guidance and direction of clinical pharmacists 

• Assist in development and execution of pharmacy-specific Care Management strategic and tactical plans including HEDIS measures and CMS Star rating improvement 

• Maintain the confidentiality of protected patient medical information at all times 

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Possible Additional Responsibilities:

• Patient Care and Provider Support and Coordination (Managed Care Operations) 

• Serve as direct patient and provider contact for pharmacy benefit information, clinical determinations and program information 

• Coordinate and triage all pharmacy inquiries received into our provider service and member service units (phone, fax, letter, electronic media) 

• Function as liaison and subject matter expert related to client Pharmacy Benefit Management (PBM) systems and processes most specifically related to drug utilization management, drug prior authorization and pharmacy claim adjudication 

• Support and process patient submitted Direct Member Reimbursement (DMR) claims and support the appeal and grievance process related to pharmacy clinical determinations 

​Qualifications - Required:

• Associate’s or Bachelor’s degree, or equivalent years of work experience

• Must demonstrate excellent interpersonal communication skills, including exceptional listening and communication skills 

• Must possess the ability to multi-task and prioritize work

• Proficiency with Microsoft Office Suite (Word, Excel, Outlook) and ability to learn multiple work-related software applications 

Please note this is