Customer Service Drug Program Specialist

Blue Cross Blue Shield of Kansas • Salina, KS • 2d ago

This job was posted by https://www.kansasworks.com : For more information, please see: https://www.kansasworks.com/jobs/13422098 Under the direction of leadership, The Customer Service Drug Programs Specialist acts as the customer service liaison with the Blue Cross and Blue Shield of Kansas (BCBSKS) Pharmacy Team and BCBSKS\'s Pharmacy Benefit Manager (PBM). The Customer Service Drug Programs Specialist assists customer service employees with their job duties, such as responding to customer inquiries and resolving issues or complaints, related to drugs administered through the PBM.

\"This position is eligible to work onsite or hybrid (9 or more days a month onsite), in accordance with our Telecommuting Policy. Applicants must reside in Kansas, Missouri or be willing to relocate to another approved state as a condition of employment.\"

Why Join Us?

Family Comes First: Total rewards package that promotes the idea of family first for all employees; including paid time off and family first leave.

Professional Growth Opportunities: Advance your career with ongoing training and development programs both through our internal Blue University and external opportunities.

Dynamic Work Environment: Collaborate with a team of passionate and driven individuals.

Make a Positive Impact: Your work will directly contribute to the health and well-being of Kansans.

Stability: 80 years of commitment, compassion, and community

Networking Opportunities: Participate in our corporate intern program and network with other interns at BCBSKS to enhance your learning opportunity.

Compensation

\$27.08- \$33.80

Non- Exempt 13

Blue Cross and Blue Shield of Kansas offers excellent competitive compensation with the goal of retaining and growing talented team members. The compensation range for this role is a good faith estimate, it is estimated based on what a successful candidate might be paid. All offers presented to candidates are carefully reviewed to ensure fair, equitable pay by offering competitive wages that align with the individual\'s skills, education, experience, and training.

**Are you ready to make a difference? Choose to work for one of the most trusted companies in Kansas.

What you\'ll do

Responsibilities:**

Support internal customer service clients by answering drug related

questions and coordinating with other areas and external entities to resolve inquiries and improve the customer experience.

Proactively identify opportunities to improve the customer

experience relating to drug benefits and PBM experiences, and report issues and complaints to management, Special Investigations Unit, BCBSKS pharmacy team and/or Pharmacy Benefit Manager (PBM) contacts (including but not limited to Clinical Drug Review Team, Medical Pharmacy Solutions Team, Specialty Team, Clinical Programs team, Client Engagement Team, etc.).

Serve on drug related teams as a Subject Matter Expert (SME) on

behalf of customer service.

Communicate formulary changes, FDA or drug company recalls, pharmacy

terminations, and other drug related topics to Customer Service.

Review and provide feedback relating to implementation of

utilization management programs.

Load prior authorizations (PAs)/overrides to Pharmacy Benefit

Manager (PBM) claim system.

Perform drug claims and PA testing.

Develop and modify Knowledge Management Tool content.

Facilitate learners through prescription drug training courses via

hybrid and virtual modes of communication.

Review logged complaints for Pharmacy Benefit Manager (PBM) drug

benefits. Report information to quarterly Pharmacy Review and Quality Assurance (PRQA) team meeting.

Review and suggest improvements of member letters and communications

relating to annual pharmacy changes and other drug related issues.

Review Pharmacy BenefitManager (PBM) claims remediation for

accuracy and communicate details and payment information to BCBSKS accounting and claims departments.

Perform claims testing to verify utilization management and other

formulary changes are implemented correctly.

Review Custom Group requests and advise if requested benefits can be

administered successfully by BCBSKS and Pharmacy Benefit Manager (PBM).

Review membership/claims issues submitted through the Benefits

Communication Team and provide guidance and data relating to drug benefits.

What you need

Knowledge/Skills/Abilities:

Effective communication skills to build relationships. Provides guidance and direction in a clear, concise, and professional manner.

Ability to interact positively with internal customers/coworkers and external vendors while demonstrating empathy, adaptability, problem-solving, and listening skills.

Exercise sound business judgment in a team environment and independently, while having the motivation and interpersonal skills necessary to effectively resolve problems and build relationships.

Strong analytical and problem-solving skills.

Strong written and verbal skills to effectively communicate drug content to customer service employees.

Similar Jobs

Home Health RN

HCA Healthcare • Salina, KS • 2d ago

Hospital & Medical

Description Introduction Do you have the career opportunities as a Home Health RN you want with your current employer? We have an exciting opportunity for you to join Wesley Healthcare at Home which is part of the nation...

2d ago

Go to Apply

Certified Nursing Assistant

Bethany Home Association • Lindsborg, KS • 5d ago

Hospital & Medical

This job was posted by https://www.kansasworks.com : For more information, please see: https://www.kansasworks.com/jobs/13419168 Certified Nursing Assistant Bethany Home Association of Lindsborg Kansas - Lindsborg, KS Po...

5d ago

Go to Apply

Registered Nurse (RN)

Bethany Home Association • Lindsborg, KS • 5d ago

Hospital & Medical

This job was posted by https://www.kansasworks.com : For more information, please see: https://www.kansasworks.com/jobs/13419175 ::: {aria-label="Description"} Summary:Under the direction of Director Of Nursing, plans, d...

5d ago

Go to Apply

Physical Therapist - Part Time

Kenwood View Health and Rehabilitation Center • Salina, KS • 1w ago

Hospital & Medical

This job was posted by https://www.kansasworks.com : For more information, please see: https://www.kansasworks.com/jobs/13417432 PT Job Summary The Physical therapist (PT) evaluates and treats residents and patients with...

1w ago

Go to Apply

Registered Nurse - FT Evening Shifts

Salina Presbyterian Manor • Salina, KS • 2w ago

Hospital & Medical

This job was posted by https://www.kansasworks.com : For more information, please see: https://www.kansasworks.com/jobs/13411222 Salina Presbyterian Manor **Start Your Career Today! Apply Online at www.SalinaPresbyterian...

2w ago

Go to Apply

Pharmacy Manager

Walgreens • Salina, KS • 2w ago

Hospital & Medical

Job Description: Job Summary: Provides empathetic pharmacy consulting services to patients regarding the effective use of medications and drug interaction awareness. Offers preventive and clinical healthcare services, in...

2w ago

Go to Apply

Advanced Medical Support Assistant

Veterans Affairs, Veterans Health Administration • Salina, KS • 3w ago

Hospital & Medical

Summary The Advanced MSA provides specialized and expert administrative patient support while working collaboratively in an interdisciplinary coordinated care delivery model. This position will be located at the Communit...

3w ago

Go to Apply

Provider Engagement Account Manager

UnitedHealth Group • Salina, KS • 15h ago

Management & Administrative

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growi...

15h ago

Go to Apply

(USA) Backroom Associate - Sam's Club

Walmart • Salina, KS • 19h ago

Position Summary... What you'll do... Maintains and processes shipments for the Club in accordance with Company policies and procedures by developing and posting delivery schedules; compiling and organizing receiving rep...

19h ago

Go to Apply

Museum Assistant

City of Salina, Kansas • Salina, KS • 1d ago

This job was posted by https://www.kansasworks.com : For more information, please see: https://www.kansasworks.com/jobs/13423476 CITY OF SALINA POSITION DESCRIPTION CLASS TITLE: Museum Assistant GR: 101 FLSA: Non-Exempt...

1d ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.