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Pharmacy Benefit Management || AZ || Onsite at Remote, Remote, USA
Email: [email protected]
http://bit.ly/4ey8w48
https://jobs.nvoids.com/job_details.jsp?id=3046461&uid=0f211f814a0345b68dc35fa11e48c050

From:

Aditya Sharma,

GVR Infotek

[email protected]

Reply to: [email protected]

Job Description

Pharmacy Benefit Management

Phoenix, Arizona(Onsite)

Highly preferred: 3-4 years of experience with Rx claims or PBM (Pharmacy Benefit Management)

Background in medical claims or related field

BCBS of Arizona. The interviews are onsite in Phoenix.. and only

PERFORMS JOB FUNCTIONS UNDER CLOSE SUPERVISION OR PEER REVIEW

Analyze PBM prescription claim and other applicable systems for medication benefit quality and accuracy

Support internal and external customers with information on benefits applicable to medication claims

Perform, evaluate, and assist in defining and improving the quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines.

Administer, interpret, and maintain current working knowledge of required BCBSAZ systems, procedures, forms and manuals

Communicate recommendations in regard to medication claim processing and benefit decisions.

Monitor and investigate reported plan set up system issues

Participates in quality initiatives; including functions that support audits, reporting, evaluation of quality opportunities and concerns, and creation and implementation of corrective actions as requested.

Resolve escalated member issues

Research & provide recommendations for accumulations issues

Logs all benefit setup issues on error tracking reports

Ideal Candidate Profile Experience:

Highly preferred: 3-4 years of experience with Rx claims or PBM (Pharmacy Benefit Management)

Background in medical claims or related field

Technical Skills:

Strong Excel or Excel-like tool proficiency

VLOOKUPs

Filtering and updating spreadsheets

Using basic formulas in spreadsheets

Comfortable handling large datasets quickly and accurately

Nice to Have:

Data entry experience with an analytical mindset

Experience in Rx claim/PBM work

Please share resume at [email protected]

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Pharmacy Benefit Management || AZ || Onsite
[email protected]
http://bit.ly/4ey8w48
https://jobs.nvoids.com/job_details.jsp?id=3046461&uid=0f211f814a0345b68dc35fa11e48c050
[email protected]
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07:27 AM 13-Jan-26


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Location: , Arizona