Pharmacy Technician - Remote | Wfh

We are seeking a dedicated and skilled Pharmacy Technician to join our dynamic team. This full-time remote role is open to residents of Oregon or Washington. As a member of our team, you will play a crucial role in supporting various medical management functions, including utilization management, pharmacy management, and care coordination. Your expertise will help ensure that our operations adhere to policies, practice guidelines, and state and federal regulations. By serving as a liaison to Oregon Health Plan members, providers, pharmacies, and healthcare personnel, you will contribute to the well-being of our community.
What We Offer
Competitive salary based on experience.
Comprehensive benefits package, including PTO, Health/Vision/Dental Insurance, 401k with company match, gym membership reimbursement, and more.
Key Responsibilities
Regulatory Compliance:
Stay up-to-date with Oregon Administrative Rules (Medicaid) related to coverage determinations.
Adhere to internal policies, Code of Conduct, Compliance Plan, and relevant regulations.
Utilization Review
Review requests for coverage of pharmacy and medical services, making consistent and well-documented decisions.
Navigate and apply the Health Evidence Review Commission Prioritized List of Health Services.
Follow utilization management guidelines accurately and achieve high inter-rater reliability scores.
Analyze claims data considering medical necessity, quality of care, and appropriateness of delivery.
Care Coordination
Assist with Medication Management program tasks, including contacting members, pharmacies, and providers.
Collaborate with other departments to coordinate medication services and resolve barriers.
Educate members and practitioners about the health plan's benefits and rights.
Qualifications
Minimum Qualifications:
Current National and Oregon Certified Pharmacy Technician (CPhT) licensure.
1+ years of pharmacy technician experience.
Strong familiarity with pharmaceutical and medical terminology.
Proficient in PC navigation, MS Office (Word, Excel, Outlook), data entry, and internet research.
Clear record for participation in federal health care programs (e.g., Medicare/Medicaid).
Preferred Qualifications
Experience in managed care.
Exceptional customer service skills for internal and external interactions.
Effective written, verbal, and interpersonal communication abilities.
Team player with excellent collaboration skills.
Self-disciplined in remote work environments, following policies and procedures.
Strong critical thinking and time management skills.
Ability to work independently and proficiently.
Inclusive mindset, considering the impact of work on diverse communities.
Experience working within diverse teams and adapting to different communication styles.
Bilingual translation capabilities are a plus.
Proficiency In MS Office Suite And Other Computer Skills.
If you are passionate about making a positive impact on healthcare management and possess the necessary qualifications, we encourage you to apply for this exciting opportunity. Join our team of professionals dedicated to improving lives through effective medical management.
Employment Type: Full-Time
Salary: $ 17.00 20.00 Per Hour