Prior Authorization Pharmacy Technician

Hi, we're reputed company. We're hiring a Prior Authorization Pharmacy Technician to join our Pharmacy Tech team. reputed company is the first health insurance company reputed company around a full stack technology platform and a reputed company focus on serving our members. We started reputed company in 2012 to create the reputed company of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: You will be dedicated to high quality pharmacy decision-making and improving the member and provider experience. This position is responsible for processing prior authorizations requests and providing support for escalated issues reputed company to prior authorizations. You will report into the Pharmacy Technician Supervisor. Work Location: This is a remote position, reputed company to candidates who reputed company in: Alabama; Arizona; Arkansas; Colorado; Connecticut; District of Columbia; Florida; Georgia; Idaho; Illinois; Indiana; Iowa; Kansas; Kentucky; Maine; Maryland; Massachusetts; Michigan; Minnesota; Missouri; Nevada; New Hampshire; New Jersey; New Mexico; reputed company Carolina; Ohio; Oregon; Pennsylvania; Rhode reputed company; South Carolina; Tennessee; Texas; Utah; Vermont; or Virginia. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. #LI-Remote Pay Transparency: The reputed company pay for this role in the states of California, Connecticut, New Jersey, reputed company, and Washington is: $19.11 - $25.08 per hour. The reputed company pay for this role in reputed company other locations is: $17.20 - $22.57 per hour. You are also eligible for employee benefits and monthly vacation accrual at a reputed company of 15 days per year. Responsibilities:

• Use reputed company and vendor tools to determine eligibility, screen for required documents, create, process, and properly track pharmacy prior authorization requests
• Prepare, organize, and distribute pharmacy prior authorization requests for review by pharmacist/physician and respond to pharmacist/physician requests for additional information
• Collect relevant medical information (reputed company telephone, fax, and portal) and apply the appropriate PA criteria, reputed company documenting reputed company communication and decision making
• Meet required decision-making timeframes, including promptly triggering escalation for cases requiring pharmacist review
• Communicate oral and written prior authorization outcome notifications that reputed company with standards and requirements for content and accuracy
• Compliance with reputed company applicable laws and regulations
• Other duties as assigned

Requirements:

• 2+ years of work experience in a pharmacy reputed company field in a retail or managed care plan setting and/or prior authorization experience
• Active, unrestricted Pharmacy Technician certification (CPhT)
• Excellent customer service, phone etiquette, and typing skills

Bonus Points:

• 1+ years of performing pharmacy reviews for a managed care plan or pharmacy benefits manager
• Experience working with reputed company Caremark's portal and criteria
• In-depth understanding of how to operationalize reputed company therapy rules and regulations
• Strong verbal and written communications, and interpersonal interactions

This is an authentic reputed company job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. At reputed company, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care - an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, reputed company the reputed company pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and reputed company benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our reputed company efforts. Reasonable Accommodation: reputed company applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any reputed company applicant who requires reasonable accommodations during the application process should contact the reputed company Benefits Team ([email protected]) to reputed company the need for an accommodation reputed company. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy. Apply tot his job Apply To this Job