Job Description

GENERAL SUMMARY:

Eligible for a $2,500 Sign-on Bonus

Eligible for Full-Time Benefits

Shift: Fulll-Time

The Pharmacy Benefits Specialist is responsible for handling drug claim adjudication issues, prescription prior authorization, and pharmacy benefit inquiries from members/patients, physicians, pharmacies, and other internal and external individuals.
Is a subject matter expert in the resolution of pharmacy benefit coverage issues and coordinating prior authorization and exception processes.

PRINCIPLE DUTIES AND RESPONSIBILITIES:

• Performs benefits investigation, prescription prior authorization, and researches financial assistance needed to ensure patients have access to medications needed.
• Interprets patient treatment plans and medical notes for purposes of facilitating patient care.
• Evaluates any pharmacy related inquiries (i.e., financial barriers, therapy management related outcomes, non-adherence to therapy) and communicates with nursing, providers, social workers and physician staff any additional requirements or potential barriers to the treatment plan.
• Performs all necessary steps during order entry to ensure order gets to final verification. Ensures the process is completed quickly, accurately, and in accordance with patients needs while maintaining the highest customer service/quality of care.
• Performs online ordering of prescriptions submitted to pharmacies.

This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and duties. It should be understood, therefore, that employees may be asked to perform job-related duties beyond those explicitly described above.

EDUCATION/EXPERIENCE REQUIRED:

• Requires a High school diploma or G.E.D. Associates degree preferred
• Requires State of Michigan Pharmacy Technician License.
• Requires a minimum of two years of previous pharmacy technician experience.
• Previous experience as a specialty pharmacy technician preferred.

Additional Details

This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.

Overview

Under the leadership of President and CEO Robert G. Riney, Henry Ford Health is a

$6 billion integrated health system comprised of six hospitals, a health plan, and 250+ sites

including medical centers, walk-in and urgent care clinics, pharmacy, eye care facilities and

other healthcare retail. Established in 1915 by auto industry pioneer Henry Ford, the health system

now has 32,000 employees and remains home to the 1,900-member Henry Ford Medical Group, one

of the nation's oldest physician groups. An additional 2,200 physicians are also affiliated with the

health system through the Henry Ford Physician Network. Henry Ford is also one of the region's

major academic medical centers, receiving between $90-$100 million in annual research funding and

remaining Michigan's fourth largest NIH-funded institution. Also an active participant in medical

education and training, the health system has trained nearly 40% of physicians currently practicing

in the state and also provides education and training for other health professionals including nurses,

pharmacists, radiology and respiratory technicians. visit .

Benefits

Whether it's offering a new medical option, helping you make healthier lifestyle choices or

making the employee enrollment selection experience easier, it's all about choice. Henry

Ford Health has a new approach for its employee benefits program - My Choice

Rewards. My Choice Rewards is a program as diverse as the people it serves. There are

dozens of options for all of our employees including compensation, benefits, work/life balance

and learning - options that enhance your career and add value to your personal life. As an

employee you are provided access to Retirement Programs, an Employee Assistance Program

(Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness, and a whole host of other benefits and services. Employee's classified as contingent status are not eligible for benefits.

Equal Employment Opportunity/Affirmative Action Employer

Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is

committed to the hiring, advancement and fair treatment of all individuals without regard to

race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,

weight, marital status, family status, gender identity, sexual orientation, and genetic information,

or any other protected status in accordance with applicable federal and state laws.

Henry Ford Health System