Job Description

To begin Treatment Authorization Requests (TAR) reviews and perform data entry upon TAR determination by pharmacy staff. Performs eligibility and benefit investigations. Supports pharmacy department with extracting and collecting data for reporting needs. Supports department's administrative needs, and participates in special projects as assigned by pharmacy technician lead, supervisor, and departmental staff.

Responsibilities

• Performs eligibility and benefit investigation to support TAR production.
• Enters data into PARx upon TAR determination by pharmacy team.
• Prioritizes, manages, and completes TAR assigned by Pharmacy Technician Lead and Supervisor.
• Supports the department's administrative needs including data processing and extraction, distribution of pharmacy manual and formulary to members and providers, preparation of meeting packets for P&T, and other pharmacy department meetings.
• Interacts and responds to providers (pharmacy and prescribers) member service inquiries regarding pharmacy benefits, billing procedures, Coordination of Benefits, and general pharmacy issues.
• Participates in special projects, assignments, and other tasks as needed.
• Other duties as assigned.

Qualifications

Education and Experience

High school diploma or equivalent, plus 2-3 years of college, technical school, or business school; related experience in managed care, hospital, or retail pharmacy.

Special Skills, Licenses and Certifications

Experience with Windows and related applications and familiarity with data base applications. Knowledge of California Medi-Cal program and benefits, TAR policies and regulations as defined by Partnership and DHCS. Typing speed of 40 wpm and knowledge of general business office machine operations. Valid California Pharmacy Technician license required or must be obtained within six (6) months of hire.

Performance Based Competencies

Must be able to work in a fast paced environment and maintain courtesy and composure when dealing with internal and external customers. Ability to prioritize work to ensure daily timeliness is met.

Work Environment And Physical Demands

More than 70% of work time is spent using a computer and telephone. When required, the ability to lift, carry, or move objects of varying size, weighing up to 25 lbs. Must be able to work in a fast-paced environment and maintain courtesy and composure. Ability to function effectively with frequent interruptions and multiple competing deadlines.

All HealthPlan employees are expected to:

• Provide the highest possible level of service to clients;
• Promote teamwork and cooperative effort among employees;
• Maintain safe practices; and
• Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

HIRING RANGE:

$28.94 - $34.00

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.