Pharmacy Technician Specialist
3 weeks ago
We are seeking a highly skilled Pharmacy Technician to join our team at Alignment Healthcare USA, LLC. As a Pharmacy Technician, you will play a critical role in supporting the day-to-day operations of our pharmacy department.
Key Responsibilities- Assist with the daily operations of various pharmacy department programs, including multiple projects and participating in plan and regulatory agency audits as necessary.
- Make high-volume outbound calls to members, prescribers, and pharmacies regarding the Adherence program.
- Assist members in refilling their medications and reaching out to prescriber's offices if additional refills are required on maintenance medications.
- Draft routine reports and correspondence.
- Support all CMS required oversight processes of PBM, including rebates, Explanation of Benefit reports, Transition Reports, and Part B vs Part D.
- Respond to inquiries from physicians, members, and pharmacies related to formulary and prescription benefits.
- Retrieve accurate, concise, applicable, and timely drug information.
- Interact with Plan's contracted PBM to ensure communications and information to other internal Plan departments as applicable.
- Interact with Plan's contracted PBM regarding Prior Authorizations, Overrides, and resolving issues pertaining to member's medications.
- Make outbound calls to pharmacies and prescribers to resolve prescription issues, such as medication requiring Prior Authorization, assist retail/mail order pharmacies in resolving third-party rejections, and reviewing daily rejections while ensuring CMS compliance.
- Interact with internal Plan departments to address pharmacy-related issues.
- Work closely with the compliance department to ensure Pharmacy Programs meet the criteria established by CMS.
- Ensure all HMO members' information is kept confidential according to HIPAA.
- Basic Computer Skills (Microsoft Outlook, Excel, Word) and related/integrated systems.
- Knowledge of Medicare/Managed Care Plans and/or PBM preferred.
- Education/Licensure: Pharmacy Technician license and/or certification preferred.
- Bilingual - English/Spanish strongly preferred or English/Chinese (Mandarin preferred) or English/Vietnamese must be able to speak fluently strongly preferred.
- Excellent verbal & phone communication (customer service) skills.
- Knowledge of pharmacy and medical nomenclature/terminology, common medication dosages, trade & generics, and medication therapy application.
- Excellent organizational skills with the ability to maintain accurate records, collect & maintain data for statistical reporting.
- Ability to multi-task with minimal direction and reason, logical thinking, and carry out instructions.
- 2-3 years related experience with minimum one year of experience in generating specific healthcare pharmacy reports and analysis.
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