Join the Cleveland Clinic team where you will work alongside passionate caregivers and provide patient-first healthcare. Here, you will receive endless support and appreciation while building a rewarding career with one of the most respected healthcare organizations in the world. The Coordinator - Pharmacy Benefit supports prior authorization processes for EHP, serving as a key resource for members, providers, and pharmacies on prescription coverage and benefit-related inquiries. This role works closely with pharmacists and providers to review and process authorization requests, finalize referrals, and manage communications, including member and provider education. While not involved in dispensing, the coordinator plays a critical role in ensuring timely access to medications, resolving issues, and providing subject matter expertise on pharmacy benefits. The position offers a collaborative environment with opportunities for growth and involvement in new initiatives. **This is a remote role in Ohio. A caregiver in this position will work Monday through Friday from 9:30am to 6:00pm with the potential flexible scheduling the future. No holidays, weekends or on-call expectations.** A caregiver who excels in this role will: + Respond to physician and member inquires relating to the prescription drug program. + Enter all benefit override requests into an internal database. + Utilize current internal database for pharmacy benefit overrides. + Generate appropriate letters and report and other requests. + Place manual benefit overrides into external vendor's (PBM) computer system. + Comply data and formats this information into the appropriate medium. + Interface with external vendor (PBM) to ensure proper benefit coding and resolve escalated issues. + Ensure proper prescription drug benefit coding and develops solutions to problems that cannot be resolved internally. + Assist the outpatient pharmacy and human resources departments with benefit coverage questions and other copay related issues. + Assist with the implementation and management of pharmacy disease management programs. + Analyze and process other reports to send out mailings or place phone calls to the appropriate members regarding benefit changes. Minimum qualifications for the ideal future caregiver include: + High School Diploma or GED + Knowledge of pharmacy terminology + Certified Pharmacy Technician (CPhT) verified through the Pharmacy Technician Certification Board (PTCB) + Minimum of six months retail pharmacy experience or Pharmacy Technician certification Preferred qualifications for the ideal future caregiver include: + Prior authorization experience **Physical Requirements:** + Requires frequent computer entry, sitting, standing and walking. + Normal or corrected vision, hearing and speech. **Personal Protective Equipment** : + Follows standard precautions using personal protective equipment as required. **Pay Range** Minimum hourly: $20.77 Maximum hourly: $31.68 The pay range displayed on this job posting reflects the anticipated range for new hires. A successful candidate's actual compensation will be determined after taking factors into consideration such as the candidate's work history, experience, skill set and education. The pay range displayed does not include any applicable pay practices (e.g., shift differentials, overtime, etc.). The pay range does not include the value of Cleveland Clinic's benefits package (e.g., healthcare, dental and vision benefits, retirement savings account contributions, etc.). Cleveland Clinic Health System is pleased to be an equal employment employer: Women / Minorities / Veterans / Individuals with Disabilities