Job Description

This position is responsible for supporting clinical and operational processes for clinical pharmacy Star measures within Medicare. The Senior Pharmacy Technician will execute member interventions to resolve any barriers preventing a member from becoming adherent to their medication regimen. This position will also be responsible for making and/or triaging calls to appropriate staff based on the complexity of the call. The Pharmacy Technician will interact with pharmacists, interns, pharmacy students and analysts to support current programs and assist in quality reviews to ensure continued process improvement.

• Monitors and liaises toll free call center, handle in-coming and make outgoing member, provider and pharmacy calls
• Assist leadership by investigating challenges and issues to determine root cause and recommend innovative solutions to bring resolution
• Independently address and resolve adherence barriers at the member, provider or pharmacy, including documenting activity and outcome
• Become a subject matter expert in all benefit designs and formularies to resolve issues real-time
• Create branch-tree logic for resolving claims issues and member complaints
• Document processes, creates FAQ sheets, training materials and trains new hires.
• Assist in the research, analysis, identification, and evaluation quality and data from assigned problems to evaluate existing and potential trends and issues.
• Assist in monitoring program initiatives, outcomes, and objectives to ensure goal attainment within defined parameters
• Assist in development of plans, reports, papers, and creation of other documents to ensure process improvements and work efficiencies

QUALIFICATIONS

• Associate’s Degree required.
• Active unrestricted Pharmacy Technician License or Pharmacy Technician Certification (PTCB) required.
• At least three (3) years’ experience in retail, hospital or managed care pharmacy preferred
• Knowledge of prescription drug names and therapeutic classes
• Experience with Medicare Part D prescription benefits is preferred
• Demonstrated leadership and project management abilities.
• Ability to make competent, independent decisions.
• Ability and proficiency in the use of computers and Company standard software specific to position.
• Strong customer service and phone skills.
• Strong verbal and written communication skills to handle complex situations
• Project management skills
• Strong ability to work independently, within a team environment, and communicate effectively with employees and clients at all levels.
• Knowledge of pharmacy claims processing; working knowledge of Medicare Part D is preferred
• Understanding of formularies and utilization management edits
• Ability to effectively present process improvements, root cause analysis or solutions in one-on-one or small staff meetings

PAY RANGE: Actual compensation decision relies on the consideration of internal equity, candidate's skills and professional experience, geographic location, market, and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $51,100 and $85,700.

EEO Statement: All qualified applicants will receive consideration for employment without regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.

Candidates are hired on an "at will" basis. Nothing herein is intended to create a contract.