Remote - Pharmacy Technician Iii - R6385

Job Summary
The Pharmacy Technician III is responsible for assisting Team Leader(s) in monitoring and oversight of incoming work flow queues (telephone/fax/e-mail), work distribution, and process management.
Essential Functions

• Assist member services pharmacy reps with pharmacy issues, overrides, and questions
• Recommend formulary alternatives to CareSource providers
• Responsible for suggesting generic or preferred formulary alternatives for requested non-preferred medications
• Review non-formulary prior authorization requests
• Has cross-trained within the department (Specialty, Medicare), when needed
• Place prior authorizations where approval is appropriate in CAS/Client Access systems
• Answer calls from providers regarding prior authorization requests, prescription coverage, and formulary issues in a timely manner
• Initiate drug denial process over to the pharmacist for drugs deemed as a denial
• Perform any other job duties as requested
• Assist Team Leader in ongoing education and communication of changes to Pharmacy Techs
• Will utilize self-opportunities for all skill sets
• Able to identify training needs
• Assist Team Leader(s) in monitoring and oversight of incoming work flow queues (telephone/fax/e-mail), work distribution, and process management
• Work on special projects when rolled out as assigned
• Willing to assist associate technicians when needed
• Monitor current processes and suggest changes when needed
• Responsible for ensuring all alternative methods of inquiries (fax, e-mail) and submissions will be answered with in a 24-hour period
• Responsible for taking pharmacy call center inquiries and responding to/resolving pharmacy claim adjudication issues
• Ability to handle and resolve provider complaints in a timely manner

Education And Experience

• Minimum of three (3) years of retail pharmacy or hospital experience is required
• High School Diploma or equivalent is required
• Minimum one (1) year managed care experience is required

Competencies, Knowledge And Skills

• Attention to detail
• Professional level telephone communication skills
• Excellent leadership experience and skills
• Adaptable to a constantly changing environment
• Ability to train, coach and provide feedback effectively
• Familiarity with medication names
• Excellent communication skills
• Decision making/problem solving
• Familiarity with medical terminology
• Time management skills
• Leadership experience and skills
• Must type 60+ words per minute (WPM)
• Ability to work independently and within a team environment
• Customer service oriented
• Excellent communication skills when speaking to providers offices, as well as pharmacies
• Knowledge of Medicaid
• Familiarity of the healthcare field
• Good trouble shooting skills
• Ability to multitask
• Critical listening and thinking skills
• Beginning level, Microsoft Word, Outlook, and Excel
• Proper grammar usage
• Computer proficient with knowledge and experience in a “Windows” environment
• Ability to work in a fast paced environment
• Proper phone etiquette

Licensure And Certification

• Pharmacy Technician Certification is required

Working Conditions

• General office environment; may be required to sit or stand for extended periods of time

Compensation Range
$38,100.00 - $61,000.00
Compensation Type
Hourly