Pharmacy Member Specialist

Remote

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Health InsuranceIndustries

Requirements

Candidates should have at least 3 years of experience in retail, mail order, or specialty pharmacy, with a focus on patient escalation issues or equivalent experience. Experience working with cross-functional teams to implement defined processes is required. The ideal candidate must be a fact-based problem solver, capable of evaluating alternatives and making sound decisions, with the ability to multitask and manage ambiguity, and a strong focus on member experience. Certified Pharmacy Technician, previous health insurance or PBM experience, and prior knowledge of clinical pharmacy programs are considered advantageous.

Responsibilities

The Pharmacy Member Specialist will support the Clinical team with pharmacy needs, including Home Infusion and specialty savings programs. They will facilitate member and provider outreach campaigns, address inquiries about coverage, medication management, prior authorizations, and pharmacy networks. Responsibilities include investigating and resolving pharmacy claims issues, educating members on their benefits and cost-saving opportunities, identifying process improvements, and supporting internal teams with pharmacy-related questions to ensure a seamless member experience.

Skills

Pharmacy benefit management

Medication management

Prior authorizations

Specialty savings programs

Pharmacy networks

Claims processing

Customer service

Medication adherence

Formulary options

Gravie

Health benefits and insurance solutions provider

About Gravie

Gravie provides health benefits by offering straightforward and affordable health plans, primarily targeting individuals and small to midsize businesses. Their main product, Comfort, stands out because it has no deductible and no copays for most common healthcare services, allowing members to access care without unexpected costs. Additionally, Comfort includes virtual care options for musculoskeletal and mental health issues. Gravie also offers a payment solution called Gravie Pay, which enables members to pay for healthcare expenses interest-free, further easing financial stress. Unlike traditional health plans, Gravie claims that Comfort members save on out-of-pocket costs, and employers switching to Gravie often see lower premium expenses. The company has a high retention rate, indicating that many employees choose to continue with the Comfort plan in subsequent years. Gravie's goal is to simplify health benefits and reduce the financial burden of healthcare for its members.

Minneapolis, MinnesotaHeadquarters

2013Year Founded

$333.3MTotal Funding

DEBTCompany Stage

Fintech, HealthcareIndustries

201-500Employees