Serving organizations statewide, 44North specializes in employee health benefits and is one of the state?s only dually licensed third party administrators and brokers providing 24/7 service to all of our clients. 44North continues to offer cutting edge products and services that employees value in their benefit package. To fuel that growth, we have another exciting opportunity as a Pharmacy Services Representative with 44 North, an Acrisure Agency Partner for our Cadillac, MI location..
Essential Duties and Responsibilities:
Assist the Pharmacy Services Manager in gathering the necessary information regarding new/existing accounts and updating information and policies in agency management system
Maintain awareness of new developments or changes with the various pharmacy benefit managers (PBM) and new Federal/State laws that may affect how our clients must administer their prescription programs, and communicate this information to clients and team members
Research and manage the application of prescription patient assistance programs whether provided by the manufacturer, charitable institutions, government or other available benefits for all specialty and high cost prescriptions with the goal of removing all cost from client plans and member responsibility. This process is meant to actively manage the process between the program, physician, patient and any other entity involved in providing data to ensure application is approved timely
Research and manage the availability of copay card programs to maximize savings to client plans and member responsibility, managing copay structure in PBM claim systems and communicating with pharmacies to manage the fill process
Enroll appropriate members into the international mail order program, working directly with international pharmacy, tracking enrollments in agency management system, and fielding calls and emails pertaining to this program
Review daily claims and reject files, identifying any rejected claims requiring attention and claims eligible for international program
Utilize various PBM claims systems to troubleshoot claims issues and place appropriate overrides
Attend and complete any training sessions or assignments as required
Perform other tasks on projects as needed
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Other Qualifications:
Proactive approach to learning
Product knowledge
Strong organizational skills, high attention to detail, responsive and self-motivated
Must have drive, empathy, energy and integrity with the ability to influence and motivate others
Team player and task-orientation
Good communication skills and courteous telephone skills
Positive Attitude
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience
Bachelor?s Degree or equivalency. Employee benefit insurance experience; or equivalent combination of education and experience, preferred
2 years of experience in Employee Benefit Insurance or Pharmacy Benefits, required
MI Health and Life License or willing to obtain license within 6-12 months in position, required
Certified Pharmacy Technician or willing to obtain license within 6-12 months in position, required
Bi-lingual in English/Spanish preferred but not required
Technology Skills
Agency Management Software experience, preferred
Proficiency in Microsoft Office applications (Word, Excel, PowerPoint, Outlook)
Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Moderate stress due to regular deadlines and daily challenges.
High finger dexterity while typing documents and forms
Occasionally lift up to 20lbs.
Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job, and reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Work is done in a temperature-controlled, non-smoking office.
Workstations are cubicles with average sides.
The noise level in the work environment is usually moderate.
Remote work available for Bi-lingual candidates (English/Spanish)