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Job description
About this Job: General Summary of Position
The Pharmacy Technician works under the direction of the health plan pharmacists to facilitate the safe and effective use of medications by enrollees/members and their providers. The Pharmacy Technician prioritizes the needs of enrollees/members and develops and sustains collaborative professional relationships.
Primary Duties and Responsibilities
Facilitates the accurate and timely processing of medication prior authorization requests.
Communicates with patients, providers, and dispensing pharmacies to support medication-related requests and other departmental initiatives.
Collects all pertinent information for Medical Reviewers (Medical Directors and pharmacists) to complete medication prior authorization clinical evaluation.
Pharmacy Operations activities including Reviewing and finalizing monthly, quarterly, and annual PBM reports. Supports maintenance of PA metrics dashboard.
Supports medication-related initiatives that align with strategic priorities with oversight from the Pharmacist. Activities may include but are not limited to outreaching to Enrollees/Members and Providers regarding HEDIS, EQRO or other quality measures.
Completes required regulatory reports that the health plan submits to the regulators.
Performs administrative tasks as requested by the departmental leadership.
Participates in the ongoing development and expansion of pharmacy initiatives, programs and continuous process improvement activities. Develops standardized operating procedures and workflows.
Supports case management and precertification team to facilitate overrides.
Creates a pharmacy resource manual for the precertification team.
Assists with website content management.
Provides polypharmacy follow-up support for patients.
Required to have availability to provide on-call coverage for pharmacy prior authorization requests received outside of normal business hours on a rotating basis.
Acts as Subject Matter Expert to support interdepartmental projects.
Minimal Qualifications
Education
High School Diploma or GED required
Associate's degree preferred
Experience
1-2 years experience as a pharmacy technician in an outpatient dispensing pharmacy required
Experience supporting quality improvement goals with focus on HEDIS preferred
Previous experience with prior authorization review processes preferred
Previous use or knowledge of Cerner or MedConnect preferred
Health Literacy Training preferred
Health Equity Training preferred
Licenses and Certifications
LPT - Licensed Pharmacy Technician required upon hire
This position has a hiring range of : USD $19.55 - USD $34.25 /Hr.
Worksite address
waldorf, MD, 20603, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.