Pharmacy Technician

2 weeks ago


New York, New York, United States MetroPlus Health Plan Full time
Job Summary

MetroPlus Health Plan is seeking a highly skilled Pharmacy Technician to join our team in the Medicare Operations department. As a Pharmacy Technician, you will play a critical role in ensuring the accuracy and efficiency of our pharmacy benefit configuration and prior authorization processes.

Key Responsibilities
  • Process and validate internal and external reports to ensure proper benefit configuration
  • Review and reconcile daily claims reports to identify and report on inconsistencies or concerns that may impact patient care
  • Validate improper coding through verification between POS and UM platform systems
  • Review and input overrides correctly to ensure claim adjudication is as intended
  • Reconcile benefit inconsistencies with members, pharmacies, and prescribers
  • Review external communications for accuracy and appropriateness
  • Assist with coordinating care between members, pharmacies, and providers to improve patient adherence for chronic medications and promote other pharmacy initiatives
Requirements
  • Associate degree with 4 years' experience as a Pharmacy Technician required
  • Pharmacy experience in a managed care environment preferred
  • Experience in auditing preferred
  • Experience in government programs (Medicare, Medicare Part D, and Medicaid) preferred
  • Proficiency with MS Word, Excel, and PowerPoint required
  • Proficiency with MS Access preferred
  • PTCB or ExCPT Pharmacy Technician Certification required

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