Clinical Pharmacy Technician II

3 days ago

Austin, Texas, United States Prime Therapeutics Full time
Job Summary

We are seeking a highly skilled Clinical Pharmacy Technician II to join our team at Prime Therapeutics. As a Clinical Pharmacy Technician II, you will play a critical role in evaluating and authorizing prior authorization pharmacy requests from prescribers. Your expertise will be essential in determining the appropriateness of medications and communicating decisions to physicians, physician's office staff, medical management staff, and pharmacists.

Key Responsibilities
  • Evaluate and authorize prior authorization pharmacy requests from prescribers using client clinical criteria.
  • Determine the appropriateness of medications and communicate decisions to relevant stakeholders.
  • Research, resolve, and document prior authorization outcomes in the pharmacy system.
  • Communicate selected prior authorization criteria, pharmacy benefit coverage, and formulary alternatives to physicians, physician's office staff, medical management staff, and pharmacists.
  • Escalate requests to a Pharmacist when extensive clinical review or denial is required.
  • Monitor the telephone system to ensure adequate staffing to maintain client services levels.
  • Assess training needs within the team and serve as a training resource, mentor, and coach to others.
  • Identify and share best practices.
  • Demonstrate, advocate, and reinforce a positive team environment.
Requirements
  • Active pharmacy technician licensure or registration in accordance with state requirements.
  • Active national certification (e.g., PTCB or ExCPT) in states that do not require licensure or registration.
  • Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.
  • In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology, and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).
  • Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.
  • Excellent written and verbal communication skills.
  • Ability to follow clinical criteria and instructions to approve prior authorization requests.
  • Minimum of 6 months dispensing or retail experience required, or equivalent internal training will be substituted.
  • Ability to identify and trouble-shoot problematic issues.
What We Offer

Prime Therapeutics offers a competitive salary range of $17.16 - $25.73 based on experience and skills. We also offer a comprehensive benefits package, including medical, dental, and vision insurance, 401(k) matching, and paid time off. Our company is proud to be an equal opportunity and affirmative action employer, and we encourage diverse candidates to apply.

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