Pharmacy Customer Service

Confidential is seeking a Pharmacy Customer Service Representative to process medication requests from healthcare providers and pharmacies. The role applies MO HealthNet criteria and clinical decision-making algorithms, makes medication pre-certification determinations, and provides accurate, professional service while managing a high volume of calls.

Responsibilities:

• The Pharmacy CSR is responsible for processing medication requests submitted primarily by phone, with some written requests, from healthcare providers and pharmacies
• Utilize healthcare experience and apply MO HealthNet criteria using an interactive application to determine review outcomes
• Interpret and apply clinical rules and decision-making algorithms related to medications under review
• Make final determinations regarding medication pre-certification based on established guidelines
• Maintain a high level of accuracy and professionalism while handling a high volume of calls throughout the shift
• Effectively multitask in a fast-paced environment

Requirements:

• Qualified candidates will have experience in one or more of the following: pharmacy services, healthcare settings, utilization review
• Prior customer service experience is required
• Experience working directly with pharmacists and physicians is required
• Pharmacy Technicians or Licensed Practical Nurses (LPNs) preferred