Job Description – Pharmacy Associate

Job Title

Pharmacy Associate

Job Summary

The Pharmacy Associate is responsible for supporting pharmacy-related operations by reviewing medication claims, processing pre-authorizations, verifying formulary coverage, and coordinating with pharmacies, healthcare providers, and policyholders. The role ensures accurate and timely processing of pharmaceutical services while maintaining compliance with company policies and regulatory requirements.

Key Responsibilities

• Review pharmacy insurance claims for accuracy, completeness, and policy compliance.
• Process medication pre-authorizations and obtain required approvals.
• Verify prescriptions against insurance benefits, exclusions, and formulary coverage.
• Coordinate with pharmacies, hospitals, physicians, and members regarding medication-related inquiries.
• Resolve pharmacy claim rejections, discrepancies, and payment issues.
• Maintain accurate pharmacy records and update medication databases.
• Support fraud detection by identifying unusual or suspicious medication claims.
• Prepare pharmacy utilization, cost analysis, and operational reports.
• Ensure compliance with Ministry of Public Health (MoPH), Qatar Central Bank (QCB), and company policies.
• Provide excellent customer service while maintaining confidentiality of medical information.

Required Skills

• Strong knowledge of pharmaceutical products and medication management.
• Understanding of pharmacy operations and health insurance claims.
• Familiarity with pharmacy information systems.
• Good analytical, problem-solving, and decision-making skills.
• Excellent communication and interpersonal skills.
• Strong attention to detail and documentation accuracy.
• Proficiency in Microsoft Office applications.

Qualification Requirements

• Educational Qualification: Bachelor's Degree in Pharmacy (B.Pharm) or Doctor of Pharmacy (Pharm.D.) from a recognized institution.
• Professional Certification: Valid Pharmacy Degree; pharmacist license or eligibility for pharmacist licensing in Qatar is preferred.
• Experience: Minimum 2–3 years of experience in pharmacy operations, hospital pharmacy, retail pharmacy, pharmaceutical services, or health insurance/TPA pharmacy claims.
• Language: Fluent in English (written and spoken); Arabic is an advantage.
• Preferred Age: Under 45 years (if required by company policy).