Pharmacy Provider Liaison

Spectraforce Technologies
United States, New York, New York
Jun 02, 2025
Job Title: Pharmacy Provider Liaison Location: Remote (Preferred: EST Time Zone) Duration: 12 Months (Potential to Extend) Shift: Monday to Friday Between 8 AM & 6 PM EST Saturday: days on rotation basis -might be involved as the program evolves. Subject to change and have flexibility Position Purpose Perform duties to act as a liaison between providers, the health plan and Corporate including investigating and resolving provider physician injectable claims issues. Perform training, orientation and coaching for performance improvement within physician practices. Communicate effectively and partner with all internal departments to ensure members and providers have a positive, successful outcome. Duties and Responsibilities Assist with coordination of healthcare personnel administered drug services at preferred sites of care. Provide seamless member and provider services through phone queue management. Answer provider calls, retrieve voicemails, and follow up with providers and members. Review prior authorizations to confirm appropriate site of care. Redirect members to alternative servicing providers based on policy. Conduct outreach via phone to providers and members. Track performance based on quality of service, successful contacts, and site of care review completion. Education and Experience Requirements Required: High School Diploma or equivalent 3+ years of experience in healthcare Preferred: Bachelor's degree in healthcare related field Certified Pharmacy Technician (CPhT) license Knowledge of health care, managed care, Medicare or Medicaid Claims billing/coding knowledge Customer service experience