Pharmacy Technician for Utilization Management

2 weeks ago

Miami, Florida, United States Palm Medical Centers Full time
Job Overview

Palm Medical Centers is a prominent primary care organization dedicated to delivering affordable and high-quality healthcare services. With a focus on managing Part D medication expenses and ensuring adherence, we aim to enhance patient outcomes while reducing costs.

The Pharmacy Technician specializing in Utilization Management will collaborate closely with the lead pharmacist to assess medication expenditures and implement strategies aimed at cost reduction while maintaining high-quality care.

Key Responsibilities:
  • Analyze the usage of high-cost medications among primary care providers and suggest equivalent generic alternatives or other suitable substitutes based on pharmacist expertise.
  • Engage with prescribers through various communication methods for prescription modifications and recommendations.
  • Advise patients on medication adherence and explore more cost-effective drug options.
  • Assist patients in accessing financial aid programs for medications.
  • Support initiatives related to medication therapy management.
  • Contribute to the development and execution of programs designed to optimize the use of targeted medications and identify cost-saving practices in managed care pharmacy.
  • Gather clinical information for programs such as Coverage Determination and Reconsiderations, as well as other initiatives that support medical center goals.
  • Adhere to departmental policies and procedures to meet organizational objectives and ensure compliance.
  • Participate in regular team meetings.
  • Assist in mentoring new team members.
  • Complete assigned objectives and projects in a timely manner.
  • Maintain professional relationships with the provider community and internal/external stakeholders.
  • Exhibit professionalism in all interactions.
  • Foster cooperative and effective workplace relationships while adhering to the company’s Code of Conduct.
  • Consult with and refer cases to the Pharmacy Director and/or medical directors as necessary.
  • Comply with workplace safety standards.
Knowledge, Skills, and Abilities:
  • Proficient in medical and pharmacy terminology, drug nomenclature, and basic pharmacology.
  • Understanding of managed care pharmacy principles and insurance coverage issues.
  • Demonstrated ability to communicate effectively and solve problems collaboratively.
  • Strong organizational skills with the capacity to manage multiple priorities.
  • Ability to work independently and handle various projects simultaneously.
  • Knowledge of relevant state and federal regulations.
  • Proactive in taking initiative and completing tasks.
  • Proficient in Microsoft Office and other computer applications.
  • Excellent verbal and written communication skills.
  • Commitment to policy adherence.
  • Ability to maintain consistent attendance to support work quality and quantity.
  • Uphold confidentiality in compliance with HIPAA regulations.
  • Skilled in establishing and maintaining positive working relationships with colleagues, clients, and healthcare providers.
Qualifications:
  • High School Diploma or GED equivalent and completion of a Certified Pharmacy Technician Training Program.
  • A minimum of 2 years of experience in the healthcare sector (hospital, managed care, physician office, etc.).
  • Active pharmacy technician license in good standing with the State Board of Pharmacy.

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