Job Description

Your Role

The Pharmacy Prior Authorization team provides efficient and accurate responses to external customers (physicians, office staff, pharmacy providers, members, and brokers) and internal team members for all outpatient pharmacy benefit inquires. The Pharmacy Technician, Intermediate will report to the Supervisor, Pharmacy Services Operations. In this role you will resolve outpatient pharmacy benefit coverage inquiries, including prescription claim processing problems, and communication of drug formulary guidelines and alternatives.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Work

In this role, you will:

• Coordinate, assist in, and support implementation of procedures and guidelines for the drug prior authorization program for the outpatient Pharmacy Benefit
• Evaluate prior authorization requests based on medication policy and operational principles
• Provide drug usage history and other pertinent pharmacy benefit related inquiries to internal business partners to assist in case specific reviews and drug evaluations
• Communicate with the physician, physician’s office staff, pharmacies, and internal business partners to assist with accurate and efficient resolution of pharmacy benefit inquiries
• Clearly communicate formulary alternatives and prior authorization criteria, and discusses pharmacy benefit coverage when required
  

Your Knowledge and Experience

• Requires a California Certified Pharmacy Technician license
• Requires 2 years of pharmacy related experience and training; or equivalent combination of education and experience
• Basic understanding of internal procedures and policies needed to ensure effective execution of assigned tasks
• Ability to multi-task, set priorities, and manage time effectively
• Strong phone and verbal communication skills along with active listening skills
  

Hybrid Virtual Work
This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.