Do you have a passion for providing exceptional customer experience? Do you have an interest in improving the health of others by collaborating with team members to solve problems that support the needs of our customers?

If so, please consider applying for our Pharmacy Specialist position! Quartz is looking for an organized, adaptable Pharmacy Technician to work as a Pharmacy Specialist. This position will be responsible for processing pharmacy related coverage decisions for all utilization management requests in accordance with standards for accuracy, timeliness, productivity, and regulatory requirements. Also, this position with will be interacting with both internal and external customers to provide and obtain information and ensures the delivery of outstanding service and quality.

Benefits:

Typical work week; Monday - Friday, 8 am - 5pm. May vary due to urgent business needs.
• Opportunities for learning new skills and advancement
• Starting pay rate: $20 /hr. based on skills and experience + robust total rewards package.

• Process and finalize all requests within turnaround time (TAT) utilizing guidelines and other applicable regulatory requirements
• Enter coverage requests into the system and prioritize as required
• Check formulary alternatives, review tried and failed medications
• Utilize drug references and verify the drug being requested is indicated and approved for the condition
• Document all related information regarding the coverage decision
• Respond to coverage requests by faxing status to the physician
• Conforms to defined roles & responsibilities and rules of engagement between coverage decisions processing and clinical decision making
• Partners with assigned clinical pharmacists to accurately and efficiently complete coverage decisions
• Accountable to achieve productivity and accuracy standards
• Analyzes, researches, and resolves coverage decision processing issues including making written or telephone inquiries to obtain information from PBM, members, physicians, or pharmacies.

• High School Diploma or equivalency is required; Bachelor's degree in a related field preferred.
• 3+ years previous experience in a health care setting, managed care, PBM, or pharmacy setting is required.
• Managed Health Care, Pharmacy and Claims Billing, Medicare Part D or a related field experience is preferred.
• Understanding of managed pharmacy benefit concepts including formularies, prior authorizations, and claim adjudication.
• Understand medical terminology and Medicare regulation.
• Certified Pharmacy Technician (CPHT) or obtain CPHT within 12 months of hire.
• Excellent oral and written communication skills.
• Excellent organizational skills.
• Excellent interpersonal skills.

This position can work 100% remotely or from one of our offices in Madison, WI or Onalaska, WI in a hybrid or full-time on-site arrangement, if preferred. Hardware and equipment will be provided by the company, but candidates must have access to high-speed, non-satellite Internet to successfully work from home.

We offer an excellent benefit and compensation package, opportunity for career advancement and a professional culture built on the foundations of Respect, Responsibility, Resourcefulness and Relationships. Quartz is a federal contractor and supports a safe, drug-free workplace. All employment offers are contingent upon successful completion of a pre-employment criminal background check and drug screening.

Quartz values and embraces diversity and is proud to be an Equal Employment Opportunity, Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, gender identity or expression, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.