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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in pharmacy benefit management, including conducting literature reviews, administering pharmacy benefits, and performing medical necessity reviews. Strong focus on member care, satisfaction, and operational improvements.
Highest-signal resume keywords
Licensed PharmacistBachelor's Degree in PharmacyMedical Necessity ReviewsPharmacy Benefit ManagementTeamwork
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Literature ReviewFormulary Exception ManagementPrior Authorization ProcessingUtilization ManagementOperational Improvement
Soft Skills
Customer ServiceCommunicationCollaboration
Tools & Technologies
Application Delivery Process
Certifications & Qualifications
Licensed Pharmacist (Pennsylvania)
Industry Keywords
Pharmacy BenefitHealth PlanMember CarePharmaceutical Benefits
About the role
Key responsibilities & impact- Perform a variety of duties, including performing extensive literature review for the development of criteria for management of the pharmacy benefit
- Administer the pharmacy benefit in conjunction with the Health Plan Pharmacy Customer Service team
- Deliver continuous, high quality member care while maximizing member satisfaction and managing appropriate utilization
- Act as a liaison between the Health Plan and its customers with respect to pharmaceutical benefits
- Perform medical necessity reviews for formulary exceptions and prior authorizations according to specified timelines
- Suggest improvements and changes to perpetually improve operations
Requirements
What you’ll need- Bachelor's Degree-Pharmacy (Required)
- Licensed Pharmacist (Pennsylvania) within 90 days
- Application Delivery Process
- Teamwork
Benefits
Comp & perks- Healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners
- Atmosphere of collaboration, cooperation and collegiality
