Company :
Highmark Inc.Job Description :
JOB SUMMARY
This position coordinates member and provider outreach activities. The role focuses on completing non‑clinical tasks, including prescriber office outreach, benefits investigations, and formulary research to ensure timely, accurate information gathering and communication.
ESSENTIAL RESPONSIBILITIES
- Conducts member outreach in a professional, courteous, and service‑focused manner, gathers and verifies, patient information prior to transferring cases to a pharmacist, ensuring completeness and accuracy. Supports timely processing of requests by following established workflows, turnaround time expectations, and regulatory requirements.
- Performs prescriber office outreach to initiate changes, obtain documentation, clarify medication information, and resolve non‑clinical case needs.
- Completes benefits investigations, including eligibility verification, formulary coverage clarification, and cost‑share determination.
- Prepares non‑clinical components of medication‑related cases for pharmacist review, ensuring all required information is assembled. Documents clearly, accurately, and thoroughly in all appropriate record systems, ensuring information is complete and up to date.
- Serves as a liaison between members, providers, and internal pharmacy teams to resolve non‑clinical issues efficiently, including identifying opportunities for improving outreach processes, documentation quality, and operational efficiency .
- Escalates clinical concerns, incomplete information, or red flags or issues to pharmacists for further review and decision‑making..
EXPERIENCE
Required
- 2 years of experience as a patient facing Pharmacy Technician in a hospital, retail, or managed care setting
Preferred
- None
SKILLS
- Strong knowledge of medical and pharmaceutical terminology
- Strong verbal and written communication skills
- Well organized, paying close attention to detail
- Ability to identify and resolve problems
- Ability to handle multiple priorities in a timely manner
- Strong interpersonal skills
- Ability to work independently or in a team environment
- Customer oriented
- Proficient with Microsoft Office products (i.e. Word, Excel, Powerpoint, etc.)
EDUCATION
Required
- High School/GED
Preferred
- Associates degree
LICENSES or CERTIFICATIONS
Required
- Certified Pharmacy Technician (CPhT)
- Registered Pharmacy Technician in Pennsylvania and/or applicable state
Preferred
- None
Language (Other than English):
None
Travel Requirement:
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office- or Remote-based
Teaches / trains others
Occasionally
Travel from the office to various work sites or from site-to-site
Rarely
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
No
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Rarely
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:
$19.27Pay Range Maximum:
$27.42Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
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For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org
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