Pharmaceutical Associate
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About the Role
We are looking for a Pharmaceutical Associate with 2–3 years of relevant pharmaceutical experience to support medication-related insurance operations, pharmacy claims processing, and formulary management.
Key Skills for This Role
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Overview
We are looking for a
Pharmaceutical Associate
with 2–3 years of relevant pharmaceutical experience to support medication-related insurance operations, pharmacy claims processing, and formulary management.
Key Responsibilities
- Review pharmacy-related insurance claims for accuracy and policy compliance.
- Process medication pre-authorizations and approvals.
- Coordinate with pharmacies, hospitals, and physicians regarding prescribed medications.
- Verify formulary coverage and recommend alternative medication options where applicable.
- Review prescriptions against insurance policy benefits and exclusions.
- Resolve pharmacy claim rejections and discrepancies.
- Support fraud detection by identifying unusual medication claims.
- Maintain pharmacy and medication databases in coordination with clinical teams.
- Prepare pharmacy utilization and cost analysis reports.
- Ensure compliance with MoPH and Qatar health insurance regulations.
Requirements
- Bachelor's Degree in Pharmacy (B.Pharm) or Doctor of Pharmacy (Pharm.D.).
- **2–3 years of relevant pharmaceutical experience.**
- Strong knowledge of pharmaceutical products and pharmacy practices.
- Understanding of health insurance claims and pharmacy benefit management.
- Knowledge of pharmacy information systems.
- Excellent analytical, communication, and documentation skills.
- Qatar pharmacist license or eligibility for Qatar pharmacist licensing is an advantage.
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