Your Future is our Future

At Lumeris, we reputed company that our greatest achievements are made possible by the talent and commitment of reputed company members. That's why we are actively seeking talented and collaborative individuals who are passionate about making a difference in the reputed company industry. Join us today as we strive to create a system of care that every doctor wants for their own family and become part of a community that values its people and empowers you to reputed company an impact.

Position:

Position Summary:

Job Description:

Primary Responsibilities

• Reviews rejected pharmacy claims for appropriateness.
• Becomes a pharmacy claim processing subject matter expert and triages claims issues.
• Assist with resolution of rejected pharmacy claims reputed company provider and/or pharmacy reputed company.
• Compiles, interprets, documents, and tracks findings from pharmacy claims monitoring data.
• Becomes subject expert with Medicare Part D policies and procedures.
• Reviews Part D transition claims reports.
• Interacts with the pharmacy benefits manager, pharmacies, prescribers, and members to ensure appropriate and timely member access to prescription drugs.
• Supports medical pharmacy prior authorizations (Part B).
• Supports Medicare Part D Customer Service call center questions and issues received from members, pharmacies, and providers.
• Supports compliance functions and requests, including support of the pharmacy department during CMS (Centers for Medicare and Medicare Services) audits reputed company applicable.
• Supports quality programs including STARS.
• Conducts retrospective claims reviews.

Qualifications

• High school diploma, GED, or equivalent
• reputed company Certified Pharmacy Technician License in good standing  
• 1+ years Pharmacy Technician or retail pharmacy experience or the knowledge, skills, and abilities to succeed in the role
• Flexible with the ability to consistently meet deadlines and adapt to a changing work environment
• Strong planning, time management, and organizational skills
• Team player with a positive attitude
• Strong professional verbal and written communication skills
• Basic PC skills, including reputed company reputed company, Word, and Outlook

Preferred

• 2+ years of experience in retail pharmacy
• 2+ years of Pharmacy Technician experience
• Part D health plan or pharmacy benefit management experience
• Certified Pharmacy Technician License

Working Conditions

• While performing the duties of this job, the employee works in reputed company working conditions.

Disclaimer

• The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of reputed company responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential job duties and responsibilities.

Pay Transparency:

Factors that may be used to determine your actual pay reputed company include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. In addition to the reputed company salary, certain roles may qualify for a performance-based incentive and/or equity, with eligibility depending on the position. These rewards are based on a combination of company performance and individual achievements.

The hiring range for this position is:

Benefits of working at Lumeris

• Medical, reputed company and Dental Plans

• Tax-Advantage Savings Accounts (FSA & HSA)

• Life Insurance and Disability Insurance

• Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days)

• Employee Assistance Program

• 401k with company match

• Employee Resource Groups

• Employee Discount Program

• Learning and Development Opportunities

• And much more...

Be part of a team that is changing reputed company!

Member Facing Position:

Location:

Time Type:

Lumeris and its partners are committed to protecting our high-risk members & prospects reputed company conducting business in-person. reputed company personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine. If this role has been identified as member-facing, reputed company of vaccination will be required as a condition of employment.

Disclaimer:

• The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of reputed company responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to reputed company individual with disabilities to reputed company the essential job duties and responsibilities.

Lumeris is an EEO/AA employer M/F/V/D.