Sr Prescription Benefit Specialist - Accredo - Remote

POSITION SUMMARY

The Sr. Prescription Benefit Specialist is responsible for using an understanding of member benefit design in order to influence members to utilize specialty pharmacy products and services by use of informative practices, and work closely along with the prescription transfer pharmacist team to ensure transition when appropriate. Contacts involve obtaining and providing information on benefit options research and resolving escalated or complex problems as assigned by the leader. Work closely along with the prescription transfer pharmacist team to ensure transition when appropriate.

ROLES & RESPONSIBILITIES

• Contact targeted member populations via inbound and outbound calls to explain and assist in maximizing the use of their Accredo Specialty pharmacy benefit options. (approximately 90% of job duties)
• Takes overflow of inbound calls from members, physicians, providers, and retail pharmacies.
• Research and understand Accredo products/services as well as member's drug benefit structure in order to effectively influence the conversion of Specialty services.
• Process overrides exceptions including make independent judgments in order to respond to complex or critical customer issues.
• Collaborate with internal and external partners when needed to resolve patient issues and answer questions in a pleasant, clear, and concise manner.
• Maintain accurate and complete documentation of all inquiries. Identify, document, and report all repetitive questions and/or problems and recommend potential solutions.
• Other special projects as assigned.

QUALIFICATIONS

• High School Diploma or equivalent required. Bachelor's degree preferred.
• 2+ years Customer Service or Contact Center experience within a Healthcare and/or Pharmacy Benefit Management environment required.
• 1+ years Accredo or Express Scripts experience working with one of the following systems, (RxHome, ESD, Ops Insight, CSP) preferred.
• Ability to professionally influence members to utilize our Specialty pharmacy products /services by use of informative practices.
• Problem-solving skills including identifying trends/ root cause and mitigation.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an hourly rate of 17 - 23 USD / hourly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.

About Evernorth Health Services

Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives.

Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you require reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.

The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.