GENERAL SUMMARY:
The Pharmacy Benefits Coordinator facilitates the operations of the Pharmacy Care Management department by organizing, improving, and implementing pharmacy benefit management policies and procedures. Major areas of responsibility include oversight of the claims processing system, development of new benefit designs and programs, organizing the prior authorization process and management of the various vendor /customer relationships. This individual also serves as a resource to both departmental co-workers and others within the organization. Works under the direction of the Manager of Pharmacy Benefits and other delegated pharmacists.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Designs and implements changes in both existing and new pharmacy benefit structures. (e.g. benefit design, claims processing, prior authorization procedures, etc.)
In conjunction with the pharmacy manager helps coordinate and improve departmental processes and procedures.
Documents and maintains departmental policies, procedures, manuals, and databases.
Represents the department at internal and external meetings.
Trains employees on pharmacy benefit procedures and policies.
Coordinates the relationship with vendors and customers (e.g. MedImpact, Medea, employer groups, physician networks, etc.)
Serves as an internal resource for complex benefit issues/cases.
Coordinates contract management with vendors (pharmacies, drug companies, etc.)
Other duties as assigned.
EDUCATION/EXPERIENCE REQUIRED:
High School Diploma.
Associate Degree or higher is preferred.
One year of pharmacy benefit management experience or the equivalent.
Two years of pharmacy technician experience or the equivalent.
Additional Information
Organization: Community Care Services
Department: Pharmacy-Utilization Mgmt
Shift: Day Job
Union Code: Not Applicable
Additional Details
This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.
Overview
Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services - from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford's care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation's most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. Learn more at henryford.com/careers .
Benefits
The health and overall well-being of our team members is our priority. That's why we offer support in the various components of our team's well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. Our team members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees classified as contingent status are not eligible for benefits.
Equal Employment Opportunity/Affirmative Action Employer
Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height, weight, marital status, family status, gender identity, sexual orientation, and genetic information, or any other protected status in accordance with applicable federal and state laws.