. Requires minimum of two (2) years experience as a Pharmacy Utilization Management Specialist. Requires prior customer service... and is responsible for supporting and assisting in the coordination of Pharmacy Services activities including claim utilization analysis...
of Pharmacy Services activities including claim utilization analysis, prescription plan design, ad-hoc reporting, correspondence... intervention with physician & pharmacy office staff to facilitate formulary compliance and generic dispensing. Process appeals...
and/or members. They are accountable for supporting and assisting in the coordination of Pharmacy Services benefits, including claim... with members, physician office staff, pharmacies and internal stakeholders for Pharmacy eligibility, coverage determination...