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Clinical Pharmacy Technician - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Newport, RI Newport, Rhode Island |
About this job
Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.
ESSENTIAL FUNCTIONS:
- Determines appropriateness for medications. Communicates decision to physicians, physician?s office staff, medical management staff and/or pharmacists.
- Researches, resolves and documents prior authorization outcomes in pharmacy system.
- Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician?s office staff, medical management staff and/or pharmacists.
- Escalates requests to Pharmacist when request requires extensive clinical review or denial.
- Researches, resolves and documents physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management.
- Performs other duties as required.
-PTCB: Certification or the ability to obtain PTCB Certification within one year of hire. Employees in states which require a Pharmacy Technician certification/registration exam may substitute state certification/registration for the PTCB.
-Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.
-In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).
-Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.
-Excellent written and verbal communication skills.
-Ability to follow clinical criteria and instructions to approve prior authorization requests.
-Minimum of 6 months dispensing or retail experience required, or equivalent internal training will be substituted.
-Ability to identify and trouble-shoot problematic issues.
ESSENTIAL FUNCTIONS:
- Determines appropriateness for medications. Communicates decision to physicians, physician?s office staff, medical management staff and/or pharmacists.
- Researches, resolves and documents prior authorization outcomes in pharmacy system.
- Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician?s office staff, medical management staff and/or pharmacists.
- Escalates requests to Pharmacist when request requires extensive clinical review or denial.
- Researches, resolves and documents physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management.
- Performs other duties as required.
General Job Information
Title
Clinical Pharmacy TechnicianGrade
16Job Family
Call_Contact Center_PhCountry
United States of AmericaFLSA Status
United States of America (Non-Exempt)Recruiting Start Date
6/23/2017Date Requisition Created
6/22/2017Minimum Qualifications
Education
GED (Required), High School (Required)License and Certifications - Required
CPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - PharmacyLicense and Certifications - Preferred
Other Job Requirements
Responsibilities
-CPT: Certification/licensure in accordance with state requirements. In the states of Florida and Michigan, license registration with the Board of Pharmacy is required without exception.-PTCB: Certification or the ability to obtain PTCB Certification within one year of hire. Employees in states which require a Pharmacy Technician certification/registration exam may substitute state certification/registration for the PTCB.
-Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.
-In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).
-Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.
-Excellent written and verbal communication skills.
-Ability to follow clinical criteria and instructions to approve prior authorization requests.
-Minimum of 6 months dispensing or retail experience required, or equivalent internal training will be substituted.
-Ability to identify and trouble-shoot problematic issues.
Competencies
Language(s)
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled