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About the Role

This position coordinates member and provider outreach activities, focusing on completing non-clinical tasks such as prescriber office outreach, benefits investigations, and formulary research to ensure timely and accurate information gathering and communication.

Responsibilities

• Conducts member outreach in a professional, courteous, and service-focused manner, gathering and verifying patient information prior to transferring cases to a pharmacist.
• 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.
• Identifies 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.

Requirements

• 2 years of experience as a patient-facing Pharmacy Technician in a hospital, retail, or managed care setting.
• Certified Pharmacy Technician (CPhT).
• Registered Pharmacy Technician in Pennsylvania and/or applicable state.
• Compliance with ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
• Compliance with HIPAA, privacy policies, and data security guidelines.
• Adherence to the company's Code of Business Conduct, applicable federal and state laws, rules, and regulations, and training requirements.

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.)

Location

• Office-based
• Remote-based

Work Type

• Full-time

Experience Level

• 2 years of experience

Education Level

• High School/GED
• Associate's degree

Salary/Compensations

• $19.66 - $27.42 per hour

Benefits

• Access to covered information, cardholder data, or other confidential customer information that must be protected at all times.

About the Company

• Highmark Inc. is an organization that adheres to ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

Equal Opportunity

• 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.
• We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
• For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org.