CA-Blue Shield of California / Customer Service / Pharmacy Customer Service Representative

Job Detail

Title:	Pharmacy Customer Service Representative
Category:	Customer Service
Plan:	CA-Blue Shield of California
City:	San Francisco
State:	CA
Type:	Full Time
Description: transformation is the opportunity Bring your customer focus and Pharmacy Technician experience as you partner with physicians, physician office staff, contracted pharmacists, patients and other BSC team members. You will help implement procedures and guidelines for the drug prior authorization program for the outpatient Pharmacy Benefit. Join Blue Shield of California and grow your career with a leader that's stirring up a change. Responsibilities: • Disseminates prior authorization criteria, pharmacy benefit coverage and formulary alternatives. • Conducts computer searches specific to drug usage history and other pertinent pharmacy benefit to assist in reviews/evaluations. • Assists pharmacists with drug utilization review programs, NCQA QI programs or other assigned projects. • Researches and resolves physician inquiries and grievances; provides essential clinical information to BSC Member Services, Administrative Review Department and Consumer Affairs to further resolve member inquires and grievances. • Serves as representative of BSC through a courteous and professional manner.
Qualifications: Requirements: • Associate's with 1+ years of pharmacy related experience and/or training; or equivalent combination of education and experience. • State Board of Pharmacy Technician certification. • Familiarity with pharmacy programs and evaluating appropriate drug use. • Proficiency with pharmacy computer and Pharmacy Benefit Management (PBM) systems. • Strong communication skills to respond to inquiries or complaints from customers, regulatory agencies or members of the business community. Our comprehensive benefits begin on your first day with medical, dental and vision coverage; 20 days PTO annually; 9 paid holidays; matching 401(k); and company pension. For more information or to apply, please reference Job No. 4542 at: blueshieldca.com/careers Blue Shield of California is an Equal Opportunity Employer. An Independent Member of the Blue Shield Association. Blue Shield of California
Req Code:	4542

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