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From Home Express Scripts Pharmacy Jobs in Oregon

Consonus Pharmacy

Pharmacy Claims Review Manager

Portland, OR · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Free access to MDLIVE - allowing access to your health benefits from anywhere * 401K With Employer ... Experience working with PBMs such as Express Scripts, CVS Caremark, OptumRx, Humana, Prime ...

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All JobsExpress Scripts Pharmacy JobsFrom Home Express Scripts Pharmacy JobsFrom Home Express Scripts Pharmacy Jobs in Oregon

From Home Express Scripts Pharmacy information

What are the key skills and qualifications needed to thrive as a from home Express Scripts Pharmacy employee, and why are they important?

To thrive at Home Express Scripts Pharmacy, you need a solid understanding of pharmacy operations, medication dispensing, and relevant pharmacy technician or pharmacist licensure. Familiarity with pharmacy management systems, prescription processing software, and HIPAA compliance is typically required. Strong attention to detail, customer service orientation, and effective communication skills help you excel in this role. These abilities ensure accurate medication delivery, regulatory compliance, and excellent patient support in a remote pharmacy environment.

What is the difference between From Home Express Scripts Pharmacy vs From Home Pharmacist?

AspectFrom Home Express Scripts PharmacyFrom Home Pharmacist
CredentialsLicensed Pharmacist, State LicenseLicensed Pharmacist, State License
Work EnvironmentRemote, pharmacy setting, customer serviceRemote, pharmacy setting, medication review
Employer & IndustryExpress Scripts, healthcare/pharmacy industryVarious healthcare providers, pharmacy industry
Search & Comparison IntentJob roles, remote pharmacy jobs, pharmacy technician comparisonPharmacist roles, remote pharmacy work, pharmacy job differences

From Home Express Scripts Pharmacy typically refers to remote pharmacy roles within the Express Scripts organization, focusing on medication management and customer support. From Home Pharmacist is a broader term for licensed pharmacists working remotely across various companies. Both roles require pharmacy licensure and involve remote work, but the specific employer and job responsibilities may differ.

What are some common challenges faced by pharmacists working from home at Express Scripts Pharmacy, and how can they be addressed?

Pharmacists working remotely with Express Scripts Pharmacy often encounter challenges such as limited face-to-face collaboration with colleagues and adapting to technology-based communication. Staying organized and maintaining clear communication through digital platforms is essential. Setting up a dedicated workspace and proactively reaching out to team members helps ensure accuracy in prescription fulfillment and patient care. Regular virtual meetings and leveraging company resources can help overcome feelings of isolation and keep team members connected.

What is a work-from-home position at Express Scripts Pharmacy?

A work-from-home position at Express Scripts Pharmacy allows employees to perform their job duties remotely instead of commuting to a physical office. These roles can include positions such as pharmacy technicians, customer service representatives, and pharmacists who handle prescription processing, medication counseling, and support services via phone or online platforms. Working remotely provides flexibility and can help maintain a better work-life balance while still ensuring high-quality service to patients. Express Scripts Pharmacy, part of Cigna, offers training and support to help remote employees succeed in their roles.

What are the most commonly searched types of Express Scripts Pharmacy jobs in Oregon?

The most popular types of Express Scripts Pharmacy jobs in Oregon are:

What are popular job titles related to From Home Express Scripts Pharmacy jobs in Oregon?

For From Home Express Scripts Pharmacy jobs in Oregon, the most frequently searched job titles are:

What job categories do people searching From Home Express Scripts Pharmacy jobs in Oregon look for?

The top searched job categories for From Home Express Scripts Pharmacy jobs in Oregon are:

What cities in Oregon are hiring for From Home Express Scripts Pharmacy jobs?

Cities in Oregon with the most From Home Express Scripts Pharmacy job openings:

From Home Express Scripts Pharmacy jobs near you

Pharmacy Claims Review Manager

Consonus Pharmacy

Portland, OR • On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 19 hours ago

Job description

Overview
Pharmacy Claims Manager
What's your wish list for the perfect job? Maybe it's to make a positive impact in the world, or to grow your career in healthcare. Maybe working with a supportive team is top priority, or to feel respected and valued.
If your answer is "all of the above," consider joining our team at Consonus Pharmacy. It's a perfect opportunity for compassionate people dedicated to people's health and well-being.
Consonus Pharmacy is a closed-door long-term care pharmacy specializing in the needs of nursing facilities, assisted living residents, and their caregivers. We are currently hiring a Pharmacy Claims Manager to join our team!
As the Pharmacy Claims Manager your responsibilities will include (but are not limited to):
The Pharmacy Claims Manager is responsible for overseeing all pharmacy claims processing operations, including prescription adjudication, third-party billing, claim rejection management, and reimbursement optimization. This position leads a team responsible for ensuring accurate and timely claim submission, resolution of claim exceptions, compliance with PBM, Medicare Part D, Medicaid, and commercial payer requirements, and adherence to NCPDP standards.
The Pharmacy Claims Manager partners closely with Billing, Customer Accounts, and Pharmacy Operations to ensure accurate reimbursement and compliance, minimize claim write-offs, and ensure exceptional service to residents, facilities, and payers. In our Long-Term Care environment, there is focus on coordination with the Credentialing & Contracting team on payer enrollment issues, and management of LTC-specific reject queues related to transition fills, hospice billing, and facility census changes.
Some benefits may include:
  • Paid training & career advancement opportunities
  • $25,000 toward ongoing education benefit
  • Generous Paid Time Off that pools vacation, sick & holiday pay in a single bucket for flexible use
  • Medical/Dental/Vision insurance
  • Free access to MDLIVE - allowing access to your health benefits from anywhere
  • 401K With Employer Match
  • Employee Assistance Program: with free access to counseling & support services

Qualifications
  • Bachelor's degree in Healthcare Administration, Business, Finance, or related field; equivalent experience considered.
  • Minimum 5 years of pharmacy claims, third-party billing, pharmacy revenue cycle, or PBM operations experience. Long - Term Care experience preferred.
  • Minimum 2 years of supervisory or management experience.
  • Strong understanding of: NCPDP claim standards, Medicare Part D, Medicaid pharmacy billing, Managed Care reimbursement, PBM claim adjudication processes, Pharmacy revenue cycle operations.
  • Experience working with PBMs such as Express Scripts, CVS Caremark, OptumRx, Humana, Prime Therapeutics, MedImpact, and Navitus.
  • Experience managing Medicare Part D, Medicaid, and dual-eligible populations
  • Advanced analytical and problem-solving skills.
  • Proficiency with pharmacy management systems and reporting tools
  • Ability to work under pressure in fast-paced environment ensuring timely and accurate billing
  • Ability to travel to other pharmacy locations as required
  • Certified Pharmacy Technician (CPhT) preferred (can obtain after hire)

EEO Statement
"Be here. Be you."
For more than 30 years, Marquis Companies and Consonus Healthcare have been serving seniors and welcoming staff of all backgrounds, skills, and perspectives. The Marquis family of companies offer a rich heritage of embracing differences and honoring individuality. We've continued to grow in our appreciation of diversity in the workplace. We know it builds strength, drives innovation, and brings valuable new perspectives and energy.
We're committed to making our workforce an even greater reflection of the people and communities we serve, and we are honored our employees have chosen to work at Marquis and Consonus. Everything we do as a company is driven by our mission to help those we serve, and each other, live the best rest of our lives.
That means you being you - without apology or compromise. We value your every uniqueness and continue to curate, nurture, and sustain an inclusive culture. It's the foundation of who we are and the evolution of our collective future.

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