Job Description
Key Responsibilities:
- Review and process Medicare Part D pharmacy benefit requests with speed and accuracy.
- Evaluate internal notes and fax requests for clinical details and ensure cases are set up correctly.
- Use sound clinical judgment and Medicare compendia to make case decisions.
- Conduct outreach to providers when additional information is needed.
- Document findings and decisions clearly, adhering to all CMS-mandated timelines.
- Maintain departmental productivity and quality standards.
- Collaborate with your team and leadership to support continuous process improvements.
Education:
- Bachelor’s Degree in Pharmacy or PharmD.
- License: Active, unrestricted Pharmacist License in state of residence.
- Screenshot of active license (with name, dates, and state) required at top of resume.
- Proficiency in Excel, Word, Access, PowerPoint, and Visio (preferred).
- Strong data entry and multitasking skills — ability to work across multiple applications simultaneously.
- Previous experience in Managed Care/PBM is a plus.
Technology Requirements
- Wired internet connection with minimum 25 Mbps download / 5 Mbps upload.
- Speedtest screenshot required on top of resume (www.speedtest.net)
- Dedicated, quiet workspace with minimal interruptions.
- Comfortable sitting and focusing for the full shift.
- Dual-screen setup recommended for optimal performance.
Schedule & Training
- Training: 8–10 weeks | Monday–Friday, 9 AM – 5:30 PM EST (no time off during this period).
- Post-training, shifts will be assigned based on business needs, including 1 weekend day or rotational weekends.
- Attendance during training is non-negotiable.
Candidate Screening Questions (Required)
- Each candidate must answer yes/no + explanation to the following on the top of their resume:
- Can you commit to the full training schedule with no time off?
- Do you have any conflicts with assigned shifts between 7 AM–8 PM EST?
- Do you have a quiet, dedicated home office space?
- Do you meet the wired internet requirements and can provide a screenshot?
- Are you able to work uninterrupted throughout your shift?
- Do you have prior data entry experience?
- Do you hold an active Pharmacist license in your state of residence? (screenshot required)
- Are you comfortable working independently in a productivity-driven environment?
- Do you bring a positive, engaged, and team-oriented attitude to your work?