Description
Clinical Pharmacy Technician II 3 MONTHS +
9 AM -5:30 PM EST 100% remote
How this role fits into the team? - Communicates decision to physicians, physicians office staff, medical management staff and/or pharmacists.
How this role fits into the team? - Communicates decision to physicians, physicians office staff, medical management staff and/or pharmacists.
Required Skills: Top 3 Must-Haves (Hard Skills) Nice-To-Haves (Hard Skills) Pharmaceutical background Call center experience and Authorization experience
Computer literate
Must-Haves (Soft Skills) Nice-To-Haves (Soft Skills) Punctuality Hard worker Self starter
Degree Requirements: High School Diploma or GED (Required)
Certification Requirements CPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements
Experience: Minimum 2 years in pharmacy experience
Job Description: - Determines appropriateness for medications. Communicates decision to physicians, physicians office staff, medical management staff and/or pharmacists.
- Researches, resolves and documents prior authorization outcomes in pharmacy system.
- Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physicians office staff, medical management staff and/or pharmacists.
- Escalates requests to Pharmacist when request requires extensive clinical review or denial.
- Monitors telephone system to ensure adequate staffing to maintain client services levels. Assesses training needs within the team.
- Serves as a training resource, mentor and coach to others. Identifies and shares best practices.
- Demonstrates, advocates and reinforces a positive team environment. Other duties as assigned.
RESPONSIBILITIES: - CPT
- Board of Pharmacy is required without exception. PTCB: Certification; Workers in states which require a Pharmacy Technician certification/registration exam may substitute state certification/registration for the PTCB.
- Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting. In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).
- Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite. Excellent written and verbal communication skills.
- Ability to follow clinical criteria and instructions to approve prior authorization requests.
- Minimum of 2 years dispensing or retail experience required, or equivalent internal training will be substituted.
- Ability to identify and trouble-shoot problematic issues.
WORK EXPERIENCE: Pharmacy 2+ years CERTIFICATIONS: CPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements
EDUCATION: High School Diploma or GED (Required)
