Pharmacy Coordinator - Pharmacy Member Outreach

Base pay is influenced by several factors including a candidate’s qualifications, relevant experience, and anticipated contributions to meet the needs of the business, along with internal pay equity and external market driven rates. The salary range displayed has not been adjusted for geographical location. This range has been created in good faith based on information known to Capital Blue Cross at the time of posting and may be modified in the future. Capital Blue Cross offers a comprehensive benefits packaging including Medical, Dental & Vision coverage, a Retirement Plan, generous time off including Paid Time Off, Holidays, and Volunteer time off, an Incentive Plan, Tuition Reimbursement, and more.At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.”The Gaps in Care Pharmacy Coordinator acts as an intake for all calls from members, providers, and pharmacies to facilitate closure of pharmacy-related HEDIS and Medicare STAR gaps. The Gaps in Care Pharmacy Coordinator performs advanced administrative/operational/member support duties that require independent initiative and judgement.Initiates and responds professionally to a high volume of calls in a timely and efficient manner, following standard operating procedures.Accurately establish and maintain member medication profiles for review by a Pharmacist.Collaborate with pharmacy peers, external and internal stake holders on communication needs and best practices.Consistently produce quality of work that is above the industry average and meet service level expectations.Skills:Excellent verbal and written communication skills: Positive and engaging demeanor; must be able to convey a pleasant and welcoming tone over the phone.Attention to detail is key to ensure accuracy of information relayed and processedSelf-motivated and able to exercise independent judgementAbility to manage multiple prioritiesTeam player with a customer-oriented approach and desire to assist peopleProblem-solving skills and ability to follow through on tasks assigned; Sense of urgency in completing tasks and meeting customer expectationsKnowledge:Knowledge and experience in the pharmacy industry, health plan pharmacy, pharmacy benefit manager and understanding prescription claims processing.Comprehension of State and Federal Laws/Regulations relating to the administration of Prescription Drug Benefits.Experience with presentation and training in a variety of audiences and settings.Proficient research and analytical skills.Experience:Previous or current call center, retail and/or alternate pharmacy setting experienceEducation and Certifications:Must have high school diploma or GED. Prefer a Bachelor’s degree in Business Administration, Healthcare Administration in a health science field or previous work experience with pharmacy benefit administration or in the PBM industry. Preference will be given to candidate with a relevant pharmacy related training, certification, or degree.Physical Demands:While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see. The employee must be able to work over 40 hours per week. The employee must occasionally lift and/or move up to 5 pounds.We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital you will work alongside a caring team of supportive colleagues, and be encouraged to volunteer in your community. We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career. And by doing your best, you’ll help us live our mission of improving the health and well-being of our members and the communities in which they live.

Created: 2026-02-06