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Remote Pharmacy Insurance Jobs in Michigan (NOW HIRING)

Becton, Dickinson and Company

Remote or field-based positions will have different workplace arrangements which will be indicated ... Life and AD&D insurance * Short-term disability coverage * Long-term disability insurance ...

Bcbsa

Director, Trade Client Relations

Three Rivers, MI · Remote

$155K - $175K/yr

This includes medical and pharmacy drug policies, cross benefit management, and rebate ... Work is generally performed in a remote setting. #LI-Remote $155,000.00 - $175,000.00 This is the ...

New

PharMerica

Strategic Account & Growth Manager

Detroit, MI · Remote

$85K - $100K/yr

... expansion of pharmacy services. The ideal candidate has 5+ years of experience in account ... This is a remote position but must reside within the territory. Territory: IN, OH, IL, PA, MI ...

Bcbsa

Legal Counsel

Three Rivers, MI · Remote

$167K - $222K/yr

Trade Relations, Client Relations, Operations and Invoicing, Pharmacy Supply Chain, IT, Analytics ... Advanced knowledge of healthcare insurance industry, including state and federal regulatory ...

New

Option Care

Chronic Practice Liaison

Lansing, MI · Remote

$48K - $80K/yr

Partner with Sales, Intake, Pharmacy, and Operations to resolve issues * Improve referral-to-start ... Minimal travel (up to ~20%) * Primarily remote with virtual engagement Due to state pay ...

Amerihealth Caritas

Care Manager II

Southfield, MI · Remote

Fully remote position; candidates must reside in Michigan * Must be willing to drive a personal ... Review the medication list, educate members on pharmacy needs, and counsel on side effects and ...

Insulet Corporation

... insurance, understand the benefits of insulin pump therapy, and ultimately improve their quality of ... Effectively manage communications with pharmacy representatives to ensure patients appropriately ...

All JobsPharmacy Insurance JobsRemote Pharmacy Insurance JobsRemote Pharmacy Insurance Jobs in Michigan

Remote Pharmacy Insurance information

What are the key skills and qualifications needed to thrive as a Remote Pharmacy Insurance Specialist, and why are they important?

To thrive as a Remote Pharmacy Insurance Specialist, you need a strong understanding of pharmacy operations, insurance verification, claims processing, and typically a background in pharmacy tech or healthcare administration. Proficiency with pharmacy management software, insurance portals, and knowledge of HIPAA regulations are crucial, and certification such as CPhT is often preferred. Exceptional attention to detail, problem-solving abilities, and clear communication skills make someone stand out in this position. These skills ensure accurate processing of insurance claims, minimize delays in patient care, and maintain compliance in a remote setting.

What are some common challenges faced when working in a remote pharmacy insurance role, and how can they be managed?

One common challenge in a remote pharmacy insurance role is effectively communicating with both patients and healthcare providers to resolve insurance claims and coverage issues, as much of the work is handled via phone or digital platforms. Additionally, staying updated on frequently changing insurance policies and formularies can be demanding. To manage these challenges, it's helpful to maintain organized digital records, participate in ongoing training sessions, and leverage collaboration tools to stay connected with team members and supervisors. Regular check-ins and open communication channels can ensure that workflow remains smooth and patient needs are promptly addressed.

What is the difference between Remote Pharmacy Insurance vs Remote Pharmacist?

AspectRemote Pharmacy InsuranceRemote Pharmacist
Required CredentialsInsurance licenses, knowledge of pharmacy policiesPharmacy degree, state licensure
Work EnvironmentInsurance companies, customer service, claims processingTelepharmacy, medication review, patient counseling
Industry UsageInsurance and healthcare sectorsHealthcare and pharmacy sectors

Remote Pharmacy Insurance involves managing insurance policies related to pharmacy benefits, focusing on claims and coverage. Remote Pharmacists dispense medications and provide clinical support remotely. While both roles require pharmacy knowledge, one centers on insurance administration, and the other on direct patient care.

What are Remote Pharmacy Insurance jobs?

Remote Pharmacy Insurance jobs involve working with pharmacy benefit management, insurance claims, and patient medication coverage from a remote location. Professionals in these roles often process insurance claims, verify prescription benefits, communicate with healthcare providers and patients, and handle billing issues. These positions may be filled by pharmacy technicians, pharmacists, or insurance specialists and require strong attention to detail, knowledge of pharmacy operations, and excellent communication skills. Remote Pharmacy Insurance jobs allow individuals to perform their duties from home or any location with internet access, making them ideal for those seeking flexible work arrangements.
What are the most commonly searched types of Pharmacy Insurance jobs in Michigan? The most popular types of Pharmacy Insurance jobs in Michigan are:
What are popular job titles related to Remote Pharmacy Insurance jobs in Michigan? For Remote Pharmacy Insurance jobs in Michigan, the most frequently searched job titles are:
What job categories do people searching Remote Pharmacy Insurance jobs in Michigan look for? The top searched job categories for Remote Pharmacy Insurance jobs in Michigan are:
What cities in Michigan are hiring for Remote Pharmacy Insurance jobs? Cities in Michigan with the most Remote Pharmacy Insurance job openings:
Remote Pharmacy Insurance jobs near you
Infographic showing various Remote Pharmacy Insurance job openings in Michigan as of July 2026, with employment types broken down into 90% Full Time, 7% Part Time, and 3% Contract. Highlights an 3% In-person, and 97% Remote job distribution.
Medicare Quality Pharmacy Specialist

Medicare Quality Pharmacy Specialist

Corewell Health

Grand Rapids, MI • On-site, Remote

$19.75 - $25.50/hr

Full-time

Medical, Vision, Retirement

Posted 13 days ago

Corewell Health rating

6.9

Company rating: 6.9 out of 10

Based on 771 frontline employees who took The Breakroom Quiz

454th of 890 rated healthcare providers

Job description

This is a fully remote position with set working hours of 8:00 AM to 5:00 PM Eastern Standard Time.
Job Summary
The Medicare Quality - Pharmacy Specialist is responsible for conducting high-volume outbound member outreach calls to support Medicare Stars programs.
This position is primarily phone-based, with the majority of the workday dedicated to making and receiving calls with Medicare members, pharmacies, and healthcare providers.
The Specialist plays a key role in improving medication adherence, closing care gaps, and supporting CMS quality initiatives through member education and care coordination with clinical pharmacists. Success in this role requires strong communication skills, attention to detail, and the ability to meet daily productivity and quality performance standards in a structured call center environment.
Essential Functions
  • Conduct high-volume outbound member outreach calls to address medication adherence gaps and improve Medicare Star measure performance (e.g., diabetes, hypertension, statin).
  • Educate members on the importance of medication adherence and assist in overcoming barriers (e.g., transportation concerns, setting up refill reminders).
  • Assist members in understanding their pharmacy benefits and refer to appropriate internal teams when needed (e.g., Care Management, Mail Order Pharmacy).
  • Identify and assist in resolving pharmacy billing issues or access barriers impacting adherence outcomes.
  • Process medication refill requests and coordinate communication between members, pharmacies, and providers.
  • Identify and transfer members to a license clinical pharmacist to resolve medication-related issues and improve member outcomes.
  • Assist in the administration of the Medication Therapy Management (MTM) program which includes scheduling CMRs, processing opt-outs, and other activities assigned to support program.
  • Document all outreach activities accurately and in accordance to departmental standards.
  • Meet or exceed daily productivity, call volume, quality, and documentation accuracy targets.
  • Ensure compliance with CMS requirements, HIPAA regulations, and organizational requirements.
  • Participate in team meetings and quality improvement initiatives aimed at enhancing Medicare Star Ratings and member experience.
  • Support special projects and organizational initiatives as assigned.

Qualifications
Required
  • 2+ years of pharmacy technician experience (retail, managed care, PBM, mail order, specialty, or call center)
  • Strong verbal communication skills with the ability to effectively engage Medicare beneficiaries.
  • Ability to work in a high-volume, production-driven call environment with extended time on the phone.
  • Demonstrated ability to meet productivity and quality performance expectations.
  • Strong organizational skills and attention to detail.
  • Basic proficiency in Microsoft Office applications.

Preferred
  • Bachelors degree or equivalent
  • Active Michigan pharmacy technician license and NABP Certified Pharmacy Technician (CPhT) certificate
  • Experience supporting Medicare Stars medication adherence measures
  • Experience in Medicare Advantage programs
  • Call center or outbound outreach experience
  • Knowledge of CMS Stars, CAHPS, and adherence-related quality metrics

About Corewell Health
As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.
How Corewell Health cares for you
  • Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.
  • On-demand pay program powered by Payactiv
  • Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
  • Optional identity theft protection, home and auto insurance
  • Traditional and Roth retirement options with service contribution and match savings
  • Eligibility for benefits is determined by employment type and status

Primary Location
SITE - Priority Health - 1231 E Beltline Ave NE - Grand Rapids
Department Name
Clinical Pharmacy Government Products - PH Managed Benefits
Employment Type
Full time
Shift
Day (United States of America)
Weekly Scheduled Hours
40
Hours of Work
8 a.m. - 5 p.m. EST
Days Worked
Monday to Friday
Weekend Frequency
N/A
CURRENT COREWELL HEALTH TEAM MEMBERS - Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.
Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.
Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.
An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.
You may request assistance in completing the application process by calling 616.486.7447.

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