Answer inbound calls and return voicemails from members, delivering exemplary customer service and support.
Troubleshoot and resolve prescription-related issues for members whose plans utilize CVS or Carelon as the PBM.
Coordinate with providers’ offices and retail/mail-order pharmacies as needed to resolve claims processing, prior authorization, and medication access issues.
Document all actions, progress, and communication in the ticketing system and Acuity, updating ticket status in accordance with internal standards.
Conduct proactive member outreach, including but not limited to disruption list communications and follow-up calls.
Collaborate closely with Pharmacy Services team members and cross-functional departments to ensure timely resolution of pharmacy-related concerns.
Perform other duties as assigned.

Active or eligible Pharmacy Technician license/certification (state-specific requirements apply).
1–2+ years of experience in a pharmacy, PBM, healthcare customer service, or related environment preferred.
Strong understanding of pharmacy operations, prescription workflows, and medication terminology.
Experience troubleshooting pharmacy or claims issues with PBMs such as CVS, Carelon, Optum, or Express Scripts (preferred).
Excellent verbal and written communication skills, with the ability to deliver clear and compassionate support.
Proficient in navigating systems such as ticketing platforms, pharmacy software, or claims tools (experience with Acuity is a plus).
High attention to detail, strong organizational skills, and ability to manage multiple priorities in a fast-paced environment.
Commitment to confidentiality, accuracy, and a positive member experience.

Pharmacy Technician

Key skills