Clinical Pharmacy Technician I-Wexford-Hybrid Position
4 weeks ago
**Job Summary**
This position plays a crucial role in the network's centralized prior authorization department. The successful candidate will be responsible for coordinating and administering the effective and efficient processing of pharmacy benefits prior authorization, ensuring compliance with all regulatory agency requirements.
**Key Responsibilities**
- Reviews pharmacy utilization management (UM) coverage requests and prepares cases for clinical review by a pharmacist and/or medical director when required.
- Applies plan-specific benefits to each case, summarizes pertinent facts, and cites applicable internal policies and guidelines.
- Resolves non-clinical issues independently and acts as a liaison between customer and provider-facing teams and the Corporate Pharmacy Department.
- Maintains regulatory compliance and resolves all cases within predetermined timeframes.
- Responsible for all preauthorization entries into applicable databases to ensure swift and appropriate payment of services deemed medically necessary.
- Engages in member and provider outreach to resolve non-clinical issues such as appeal initiation requests, processing errors, and fulfilling notification requirements.
**Requirements**
- 2 years of experience as a Pharmacy Technician in a hospital, retail, or managed care setting.
- Strong knowledge of medical and pharmaceutical terminology.
- Strong verbal and written communication skills.
- Well-organized, paying close attention to detail.
- Ability to identify and resolve problems.
- Ability to handle multiple priorities in a timely manner.
- Strong interpersonal skills.
- Ability to work independently or in a team environment.
- Customer-oriented.
- Proficient with Microsoft Office products.
**Education and Certifications**
- Associate degree.
- Certified Pharmacy Technician (CPhT) from Pharmacy Technician Certification Board.
**Language and Travel Requirements**
English is the primary language of communication. Travel requirements are minimal, with occasional visits to the Corporate Pharmacy Department.
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