VanderHouwen
Pharmacy Operations Specialist (Remote)
Our client is seeking a detail-oriented and service-driven Pharmacy Operations Specialist to support pharmacy utilization management and authorization workflows in a fast-paced, regulated environment. This role is ideal for someone who combines strong analytical skills with empathy, accuracy, and the ability to communicate clearly with both clinical and non-clinical partners. The successful candidate thrives in structured processes, manages multiple priorities with ease, and plays a key role in supporting compliant, member-focused pharmacy operations.
Pharmacy Operations Specialist (Remote) Responsibilities
Process and review pharmacy prior authorization requests across multiple intake channels while meeting regulatory and accreditation standards.
Apply established clinical and pharmacy policy criteria accurately to authorization and benefit determinations.
Review member eligibility, claims history, and pharmacy benefit information using PBM and related systems.
Communicate authorization decisions and pharmacy information to members, providers, and internal teams through written and verbal channels.
Support daily pharmacy operations, issue resolution, and implementation of new pharmacy or clinical programs as needed.
Pharmacy Operations Specialist (Remote) Qualifications
High school diploma or equivalent required; associate or bachelor’s degree preferred.
Two or more years of experience in a professional, healthcare, or pharmacy-related setting.
Prior exposure to managed care, pharmacy benefits, or utilization management environments preferred.
Strong customer service background with experience supporting members and/or providers by phone or email.
Demonstrated attention to detail, strong data entry skills, and the ability to multitask in a results-driven environment.
Compensation: (DOE) VanderHouwen Contractors Enjoy Exceptional Benefit Perks! As an eligible contract employee with VanderHouwen, you’ll have access to a full suite of benefits designed with your well-being in mind. Our comprehensive package includes medical, dental, vision, life insurance, short- and long-term disability, and a matching 401(k) to help secure your future.
VanderHouwen is an Equal Opportunity Employer and participates in E-Verify. VanderHouwen does not discriminate based on race, color, religion, sex, national origin, age, disability, or any other characteristic protected by applicable local, state, or federal civil rights laws.
Thank you for your interest in applying for this position! Please fill out the fields below. Your profile will be reviewed with the rest of the applicants.
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Pharmacy Operations Specialist (Remote) Responsibilities
Process and review pharmacy prior authorization requests across multiple intake channels while meeting regulatory and accreditation standards.
Apply established clinical and pharmacy policy criteria accurately to authorization and benefit determinations.
Review member eligibility, claims history, and pharmacy benefit information using PBM and related systems.
Communicate authorization decisions and pharmacy information to members, providers, and internal teams through written and verbal channels.
Support daily pharmacy operations, issue resolution, and implementation of new pharmacy or clinical programs as needed.
Pharmacy Operations Specialist (Remote) Qualifications
High school diploma or equivalent required; associate or bachelor’s degree preferred.
Two or more years of experience in a professional, healthcare, or pharmacy-related setting.
Prior exposure to managed care, pharmacy benefits, or utilization management environments preferred.
Strong customer service background with experience supporting members and/or providers by phone or email.
Demonstrated attention to detail, strong data entry skills, and the ability to multitask in a results-driven environment.
Compensation: (DOE) VanderHouwen Contractors Enjoy Exceptional Benefit Perks! As an eligible contract employee with VanderHouwen, you’ll have access to a full suite of benefits designed with your well-being in mind. Our comprehensive package includes medical, dental, vision, life insurance, short- and long-term disability, and a matching 401(k) to help secure your future.
VanderHouwen is an Equal Opportunity Employer and participates in E-Verify. VanderHouwen does not discriminate based on race, color, religion, sex, national origin, age, disability, or any other characteristic protected by applicable local, state, or federal civil rights laws.
Thank you for your interest in applying for this position! Please fill out the fields below. Your profile will be reviewed with the rest of the applicants.
#J-18808-Ljbffr