Pharmacy Benefits Specialist, Medicare I - (Akron, OH)

Pharmacy Benefits Specialist, Medicare I SummaCare, Inc., a regional health insurance company based in Akron, Ohio, is looking for an individual to monitor PBM activities related to Medicare Part D. Serves as a Subject Matter Expert (SME) for Medicare pharmacy benefit questions, concerns, and issues from internal and external customers. Critical functions and Responsibilities- Serves as Subject Matter Expert (SME) for the Medicare pharmacy benefits and Medicare drug medical benefits. - Provides administrative support to the Pharmacy Operations area including answering and responding to member questions related to prescription benefits, reviewing and responding to faxes, uploading and updating documents and web sites, and creating, running and distributing reports via MedImpact's MedOptimize software. - Monitors and assists with oversight of PBM activities. - Performs daily monitoring of Coverage Determinations, Denied Claims, Hospice and ESRD claims.