Provides support for pharmacy technician activities. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care.
Shift(s) available: Monday-Friday
8:00 AM -4:30 PM EST
11:00 AM-7:30 PM EST
12 PM-8:30 PM EST
Essential Job Duties
• Performs initial receipt and review of non-formulary or prior authorization requests against pharmacy plan approved criteria; requests additional information from providers as needed to properly evaluate requests.
• Accurately enters approvals or denials of requests.
• Facilitates prior authorization requests within established pharmacy policies and procedures.
• Participates in the development/administration of pharmacy programs designed to enhance the utilization of targeted drugs and identification of cost-saving pharmacy practices.
• Identifies and reports pharmacy departmental operational issues and resource needs to appropriate leadership.
• Assists Molina member services, pharmacies, and health plan providers in resolving member prescription claims, prior authorizations, and pharmacy service access issues.
• Articulates pharmacy management policies and procedures to pharmacy/health plan providers, Molina staff and others as needed.
Required Qualifications
• At least 2 years pharmacy technician experience, or equivalent combination of relevant education and experience.
• Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice.
• Ability to abide by Molina policies.
• Ability to maintain attendance to support required quality and quantity of work.
• Ability to maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA).
• Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.
• Excellent verbal and written communication skills.
• Microsoft Office suite (including Excel), and applicable software program(s) proficiency.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Molina Healthcare is a FORTUNE 500 company that is focused exclusively on government-sponsored health care programs for families and individuals who qualify for government sponsored health care.
Molina Healthcare contracts with state governments and serves as a health plan providing a wide range of quality health care services to families and individuals. Molina Healthcare offers health plans in Arizona, California, Florida, Idaho, Illinois, Kentucky, Massachusetts, Michigan, Mississippi, Nevada, New Mexico, New York, Ohio, South Carolina, Texas, Utah, Virginia, Washington and Wisconsin. Molina also offers a Medicare product and has been selected in several states to participate in duals demonstration projects to manage the care for those eligible for both Medicaid and Medicare.
