Clinical Pharmacy Technician Ii -Remote

Clinical Pharmacy Technician II -REMOTEEvaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.

• Monitors telephone system to ensure adequate staffing to maintain client services levels.
• Assesses training needs within the team. Serves as a training resource, mentor and coach to others. Identifies and shares best practices.
• Other duties as assigned.
• 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.
• Demonstrates, advocates and reinforces a positive team environment.

• Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.
• If state does not require an exam for licensure/registration, must possess both active pharmacy technician licensure or registration in accordance with state requirements AND an active national certification (e.g., PTCB or ExCPT).
• 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.).
• Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.
• In states that do not require licensure or registration, must have an active national certification (e.g., PTCB or ExCPT).
• Minimum of 2 years dispensing or retail experience required, or equivalent internal training will be substituted.
• Must have an active pharmacy technician licensure or registration in accordance with state requirements.
• Ability to follow clinical criteria and instructions to approve prior authorization requests.
• Excellent written and verbal communication skills.
• Ability to identify and trouble-shoot problematic issues.

PharmacyGED, High SchoolCPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy - PharmacyPotential pay for this position ranges from $16.82 - $25.23 based on experience and skills. Pay range may vary by 8% depending on applicant location.