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Certified Pharmacy Technician

Certified Pharmacy Technician

Amerit ConsultingSan Francisco, CA, US
16 hours ago
Job type
  • Temporary
Job description

Job Description

Client Overview :

Our client, a major PBM (Pharmacy Benefit Services) entity owned by 20 non-profit health plans serving >

33 million members and benefits manager of government programs including Medicare and Medicaid, seeks an accomplished Certified Pharmacy Technician.

POSITION : Certified Pharmacy Technician - REMOTE

LOCATION : 100% REMOTE || Candidate should be in California

DURATION : 6 months contract with potential of extension / conversion to FTE

NO Time-Off policy by the client during the Training period i.e., 1st 4 weeks.

IMPORTANT Remote / Work-From-Home related :

  • Equipment will be provided.
  • Candidate MUST have a high-speed wired internet connection. Wi-Fi / Wireless connections are not allowed as a violation of policy and can lead to a breach of Private Health Information (PHI).
  • Candidate MUST have a reliable home-office environment.
  • Candidate MUST be on camera during training / work hours, especially during attendance calls.
  • Candidate MUST follow business casual dress code during working hours.

What we need for the submission :

  • An updated copy of your resume.
  • Copy of diploma / degree (highest earned).
  • Job Responsibilities :

  • The Pharmacy Technician is responsible for evaluating and authorizing approval of prior authorization pharmacy requests from prescribers received by telephone and / or fax using client criteria. Primary duties may include, but are not limited to :
  • Determines appropriateness for medications. Communicates decisions to physicians, physician`s office staff, medical management staff, and / or pharmacists.
  • Researches, resolves, and documents prior authorization outcomes in the pharmacy system.
  • Communicates selected prior authorization criteria, pharmacy benefit coverage, and formulary alternatives to physicians, physician`s office staff, medical management staff, and / or pharmacists.
  • Escalates requests to Pharmacist when request requires extensive clinical review or denial.
  • Researches, resolves, and documents physician or client inquiries and grievances and provides verbal or written results to the client, prescriber, provider, and / or management.
  • Verifies member information and inputs data for the pharmacists.
  • Educates members on pharmacy-based rules related to prescriptions and medication resources or assistance programs.
  • Processes prior authorization requests from physicians’ offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations.
  • Provides resolution to grievances and appeals issues.
  • Maintains record keeping of prior authorizations, rebates, and monthly reports.
  • Requirements :

  • Requires High School diploma or GED, and 2 years of pharmacy experience.
  • Current National Certification and State Pharmacy Tech Certification based on applicable state(s) are required.
  • 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 Windows-based applications and MS Office Product Suite.
  • Ability to follow clinical criteria and instructions to approve prior authorization requests.
  • Preferred Qualifications :

  • Prior call center experience is strongly preferred.
  • Medical terminology training, pharmaceutical terminology experience, and / or experience in the medical, insurance or pharmaceutical field are preferred.
  • Specialty or retail pharmacy industry experience, previous reimbursement experience, and / or working in a health plan / health care setting.
  • Ability to respond to escalated concerns in a calm and professional manner in an attempt to prevent further escalations.
  • NOTE :

  • Candidates who are offered a position are required to pass pre-employment drug and background screening.
  • Create a job alert for this search

    Certified Pharmacy Technician • San Francisco, CA, US

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