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Pharmacy Coordinator 1

Spectraforce Technologies
United States, North Carolina, Raleigh
500 West Peace Street (Show on map)
Aug 05, 2025

Position Title: Pharmacy Coordinator 1

Work Location: Remote - Nationally sourced (PST candidate preferred)

Assignment Duration: 6 months (with Possibility to extend or convert)

Work Schedule: Monday-Friday (8 AM to 4:30 PM). No overtime, and we can be flexible on the start/end time.

Work Arrangement: Remote - Nationally sourced

Position Summary:




  • Perform duties to support the efforts pharmacy department in the development, coordination, and maintenance of the health plan's pharmacy program.




Key Responsibilities:




  • Receive and respond to provider and pharmacy calls regarding the prior authorization and formulary process



  • Perform review of pharmacy and override process in compliance with pharmaceutical related company and State guidelines



  • Track and trend overrides to ensure criteria have been met, audit for prior authorizations, analyze cost and determine utilization patterns



  • Resolve complaints and grievances related to the pharmacy network in conjunction with the Pharmacy team



  • Assist Provider Relations and various departments with educating providers on the health plan's pharmacy process



  • Assist with the pharmacy utilization review and reporting process



  • Collaborate with Quality Improvement department with various meeting preparation and transcription of minutes



  • Assist with members' inquiries related to the formulary process



  • Performs other duties as assigned



  • Complies with all policies and standards




Qualification & Experience:




  • High school diploma or equivalent



  • 3+ years of pharmacy experience, preferably in a managed care environment



  • Medicare and/or Medicaid experience preferred



  • Microsoft Office Experience - Excel, Word, Outlook, Visio



  • Pharmacy Technician license preferred, not required



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