Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP operates a portfolio of health plan products under several different legal structures: InterCommunityHealth Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services' self-funded employee health benefit plan. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services' mission of Building Healthier Communities Together. This is a remote position in which we are able to employ in the following states: Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin

JOB SUMMARY/PURPOSE

Coordinates, monitors and documents pharmacy benefit administration processes for all lines of business. Facilitates professional communication to ensure processes are completed in a member-centered manner with adherence to quality and timeline standards. Applies advanced level process knowledge to provide high quality work product and adherence to timeline requirements. Provides first level response to internal questions and concerns for the pharmacy team. Applies expert level pharmacy benefit knowledge to provide informal oversight and staff training. May participate in department or health plan projects and/or committees.

EXPERIENCE/EDUCATION/QUALIFICATIONS

High school diploma or equivalent required. One (1) year customer service or pharmacy experience required. Six (6) months managed care pharmacy benefits and services related experience required. Certified Oregon Pharmacy Technician License required. Experience and/or training in the following required: Word processing and spreadsheet development. Medical terminology. Computer applications. Communication. Data analysis and process improvement.

KNOWLEDGE/SKILLS/ABILITIES

Effective written and verbal communication skills to perform group presentations, tactfully discuss issues, and listen to and understand concepts, rules and procedures. Ability to work with all levels within the organization, facilitate communication, and effectively document related activities. Ability to identify complex problems, review related information, employ creativity and alternative thinking to develop and evaluate options and implement solutions. Ability to respond quickly and appropriately to situations that may arise with high risk or diverse patient/customer populations. Ability to adjust actions in relation to others and adapt to offer best possible customer service to patients/customers. Ability to work, function and communicate on a multi-disciplinary team. Possess the knowledge and skills to develop constructive and cooperative working relationships with others and maintain them over time. Ability to organize, plan and prioritize work to complete within required time frames and to follow-up on pending issues. Ability to perform multiple tasks simultaneously and thrive in dynamic fast-paced environments and under pressure. Knowledge of principles and processes for providing customer service. This includes customer needs assessment, meeting quality standards for services and evaluation of customer satisfaction.

PHYSICAL DEMANDS

Rarely (1

• 10% of the time) Occasionally (11
• 33% of the time) Frequently (34
• 66% of the time) Continually (67
• 100% of the time) CLIMB
• STAIRS LIFT (Floor to

Waist:

0

• 36") 0
• 20 Lbs LIFT (Knee to chest: 24
• 54") 0
• 20 Lbs LIFT (Waist to

Eye:

up to 54") 0

• 20 Lbs CARRY 1-handed, 0
• 20 pounds

BEND FORWARD

at waist KNEEL (on knees)

STAND WALK

• LEVEL

SURFACE ROTATE TRUNK

Standing REACH

• Upward PUSH (0
• 20 pounds force) PULL (0
• 20 pounds force)

SIT CARRY

2-handed, 0

• 20 pounds

ROTATE TRUNK

Sitting REACH

• Forward

MANUAL DEXTERITY

Hands/wrists

FINGER DEXTERITY PINCH

Fingers GRASP Hand/Fist Location:

Samaritan Health Services

• SHS Health Plan Ops

•

Clin Ser Schedule:

1.0 (80 hrs/pp), Day