Job Summary

Assists Pharmacy Customer Service leadership in processing provider, and member prior authorization requests. Works with the pharmacy team in implementing policies to manage pharmacy benefits.
Job Duties


Hybrid work location: Danville Pennsylvania

Rotating Weekend and Holiday coverage


+ Maintains understanding of all policies and procedures related to the pharmacy benefit.

+ Provides the highest level of customer service and support to members and physicians.

+ Adheres to all regulatory standards.

+ Works with Pharmacists to resolve clinical issues with providers in a timely manner.

+ Documents accurately all inquiries and prior authorization requests according to departmental policy.

+ Determines appropriateness of pharmacy benefits under corresponding lines of business.

+ Contacts providers and members to communicate the details of service, requests additional informat...