Job Description
**Become a part of our caring community**
As a Senior Pharmacy Claims Professional, you will serve as a subject matter expert for pharmacy within the Wisconsin market, supporting the WI FIDE SNP and Medicaid OTC programs. You will be responsible for researching pharmacy claims, resolving complex pharmacy-related issues, and collaborating closely with care management teams. Reporting to the Associate Director, FCP Clinical and Pharmacy, you will work with Humana Pharmacy Solutions and CenterWell to ensure member needs are met efficiently and effectively. You will contribute to process improvements, uphold compliance with regulatory standards, and act as a strategic resource for the Wisconsin market. Leveraging your expertise, you research and resolve pharmacy inquiries, partner with care management and pharmacy teams to address member concerns and influence departmental strategies. You are empowered to make independent decisions on complex issues and exercise significant latitu...
As a Senior Pharmacy Claims Professional, you will serve as a subject matter expert for pharmacy within the Wisconsin market, supporting the WI FIDE SNP and Medicaid OTC programs. You will be responsible for researching pharmacy claims, resolving complex pharmacy-related issues, and collaborating closely with care management teams. Reporting to the Associate Director, FCP Clinical and Pharmacy, you will work with Humana Pharmacy Solutions and CenterWell to ensure member needs are met efficiently and effectively. You will contribute to process improvements, uphold compliance with regulatory standards, and act as a strategic resource for the Wisconsin market. Leveraging your expertise, you research and resolve pharmacy inquiries, partner with care management and pharmacy teams to address member concerns and influence departmental strategies. You are empowered to make independent decisions on complex issues and exercise significant latitu...