Skip to main content
Search Jobs
Search

Let us search jobs for you based on the skills and experience listed in your LinkedIn profile.

Start Matching Jobs
close message

As part of Molina’s response to the COVID-19 pandemic, unless otherwise prohibited by law, new hires with a start date of November 1, 2021 or later will be required to be fully vaccinated.

Customer Service Representative, Pharmacy - Remote

Molina Healthcare Midvale, Utah Job ID 2008342
Apply Now

This position is currently remote due to COVID, but may (or may not) go back into the Midvale, Utah office in the fall. This position is Monday through Friday with scheduled hours between 8:00 am to 6:30 pm (ex. 8:30-5, 8-4:30, 9:30-6, etc.). 

Molina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal and state laws. Jobs in this family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services (such as, therapeutic drug monitoring, drug regimen review, patient education, and medical staff interaction), and oversight (establishing and measuring performance metrics with regard to patient outcomes, medications safety and medication use policies).

Knowledge/Skills/Abilities

  • Handles and records inbound pharmacy calls from members, providers and pharmacies to meet departmental and CMS standards.
  • Provides coordination and processing of pharmacy prior authorization requests and/or appeals.
  • Explains Point of Sale claims adjudication, state CMS policy/guidelines, and any other necessary information to providers, members and pharmacies.
  • Assists with clerical services/tasks and other day-to-day operations as delegated.
  • Effectively communicates plan benefit information, including but not limited to, formulary information, copay amounts, pharmacy location services and prior authorization outcomes.
  • Assists member and providers with initiating oral and written coverage determinations and appeals.
  • Records calls accurately in call tracking system.
  • Maintains specific quality and quantity standards.
Required Education
High School Diploma or GED equivalent

Required Experience
1-3 years of call center or customer service experience in healthcare

Preferred Education
Associate's Degree

Preferred Experience
  • Experience with Medicare Part D or other insurances
  • 3-5 years healthcare industry experience


To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Type: Full Time Posting Date: 10/08/2021

ABOUT OUR LOCATION

View Map

Job Alerts

Sign up to receive automatic notices when jobs that match your interests are posted.

By uploading your resume you are not submitting an application for employment

Interested InSelect a job category from the list of options. Search for a location and select one from the list of suggestions. Finally, click “Add” to create your job alert.