Prescription (RX) Vendor Coordinator

Imagine360 is currently seeking a Prescription (RX) Vendor Coordinator to join our team. The Prescription (RX) Drug Benefit Coordinator is the subject-matter-expert regarding pharmacy-related questions and concerns for the i360 organization and our vendor partners. This includes responding to general inquiries, addressing urgent member issues, implementing new procedures to accommodate changes in the healthcare industry, and working closely with other internal teams to provide pharmacy support.

Position Location: 100% Remote

Responsibilities include but are not limited to:

• Respond to client, pharmacy, or customer requests in a timely manner.
• Acts as a point of contact with the Prescription Benefit Manager (PBM) vendors.
• Accurately implements new Plan set-up and Plan Benefit changes to PBM vendor Reviews and maintains plan parameters for prescription plans.
• Audits plan set up/changes for accuracy. Coordinates eligibility with the PBM.
• Review and approve client ID cards and plan docs to ensure accuracy on behalf of Rx Services.
• Run requested reports for i360 and its clients; customizes per client requests.
• Customer Service: acts as a role model in demonstrating the core values in customer service delivery.
• Resolve any HelpDesk tickets or Client Change Requests assigned to the Rx Services queue.
• Respond quickly to any urgent eligibility, claim, or accumulator requests.
• Coordinate with internal IT teams to address and resolve any required pharmacy file transmission issues with clients.
• Resolve any HelpDesk tickets or Client Change Requests assigned to the Rx Services queue.
• Coordinate with internal teams and vendor partners to address and resolve member issues including eligibility and drug coverage.
• Appropriately escalates difficult issues up the chain of command.
• Trains new employees/and cross departmentally as assigned.
• Explains and demonstrates duties and proper procedures in performing duties.
• Serves on committees, work groups, and/or process improvement teams, as assigned, to assist in improving quality/customer satisfaction.
• Collaborates with others and cross-departmentally to improve or streamline procedures.
• Develops new or improves current internal processes to improve quality
• Recognizes and alerts appropriate supervisor of trends within their scope of responsibility that fall outside of quality parameters.
• Performs self-quality monitoring to develop and execute plans to meet established goals.
• Provides ongoing feedback to help optimize quality performance.
• This job description in no way states or implies that these are the only duties to be performed by this employee. The employee will be required to follow any other instructions and to perform any other duties requested by his/her supervisor.

Required Experience / Education:

• Associates degree or equivalent experience
• Two years of experience in a pharmacy or medical setting

Preferred Experience/ Education:

• Two years of experience in a pharmacy or medical setting
• Two years of experience in a pharmacy or medical setting

Skills and Abilities:

• Remote work capabilities
• Proficient mathematical, 10-key and typing skills
• Working knowledge of computers and software including but not limited to Microsoft Office products
• Demonstrated organizational skills, problem-solving, analytical skills and detail oriented
• Demonstrated ability to remain neutral and maintain confidentiality
• Strong written and oral communication skills
• Demonstrated ability to work independently, prioritize workloads multi-task and manage priorities to meet deadlines

What can Imagine360 offer you?

• Multiple Health Plan Options
• Company paid employee premiums for disability and life insurance
• Parental Leave Policy
• 20 days PTO to start / 10 Paid Holidays
• Tuition reimbursement
• 401k Company contribution
• Professional development initiatives / continuous learning opportunities
• Opportunities to participate in and support the company's diversity and inclusion initiatives

Want to see our latest job opportunities? Follow us on LinkedIn

Imagine360 is a health plan solution company that combines 50+ years of self-funding healthcare expertise. Over the years, we've helped thousands of employers save billions on healthcare. Our breakthrough total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-focused solutions.

Imagine360 is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

**RECRUITMENT AGENCIES PLEASE NOTE: Imagine360 will only accept applications from agencies/business partners that have been invited to work on a specific role. Candidate Resumes/CV's submitted without permission or directly to Hiring Managers will be considered unsolicited, and no fee will be payable. Thank you for your cooperation**