Company :

Highmark Inc.

Job Description :

JOB SUMMARY

This position coordinates member and provider outreach activities. The role focuses on completing non‑clinical tasks, including prescriber office outreach, benefits investigations, and formulary research to ensure timely, accurate information gathering and communication.

ESSENTIAL RESPONSIBILITIES

Conducts member outreach in a professional, courteous, and service‑focused manner, gathers and verifies, patient information prior to transferring cases to a pharmacist, ensuring completeness and accuracy. Supports timely processing of requests by following established workflows, turnaround time expectations, and regulatory requirements.
Performs prescriber office outreach to initiate changes, obtain documentation, clarify medication information, and resolve non‑clinical case needs.
Completes benefits investigations, including eligibility verification, formulary coverage clarification, and cost‑share determination.
Prepares non‑clinical components of medication‑related cases for pharmacist review, ensuring all required information is assembled. Documents clearly, accurately, and thoroughly in all appropriate record systems, ensuring information is complete and up to date.
Serves as a liaison between members, providers, and internal pharmacy teams to resolve non‑clinical issues efficiently, including identifying opportunities for improving outreach processes, documentation quality, and operational efficiency .
Escalates clinical concerns, incomplete information, or red flags or issues to pharmacists for further review and decision‑making..

EXPERIENCE

Required

2 years of experience as a patient facing Pharmacy Technician in a hospital, retail, or managed care setting

Preferred

None

SKILLS

Strong knowledge of medical and pharmaceutical terminology
Strong verbal and written communication skills
Well organized, paying close attention to detail
Ability to identify and resolve problems
Ability to handle multiple priorities in a timely manner
Strong interpersonal skills
Ability to work independently or in a team environment
Customer oriented
Proficient with Microsoft Office products (i.e. Word, Excel, Powerpoint, etc.)

EDUCATION

Required

High School/GED

Preferred

Associates degree

LICENSES or CERTIFICATIONS

Required

Certified Pharmacy Technician (CPhT)
Registered Pharmacy Technician in Pennsylvania and/or applicable state

Preferred

None

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office- or Remote-based

Teaches / trains others

Occasionally

Travel from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

$19.66

Pay Range Maximum:

$27.42

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

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Highmark Health

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