SCHEDULE: Monday - Friday, 12PM-8PM EST
Certified, highly motivated, experienced pharmacy technician effectively communicates with members, clients, and providers regarding pharmacy benefits and clinical administration. Assist Clinical Pharmacist in operation of Clinical Services Department. This includes, ensuring that members get overrides processed in a timely fashion and that all plans process correctly. Ensures compliance with all guidelines in processing Coverage Determination requests for both Medicare Part D and Commercial members.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:
- Coverage Determination (CD) and Prior Authorization (PA)
- CD/PA Renewals
- Clinical Program referral coordination
- Independent Task Management
- Able to leverage resources to improve accuracy and efficiencies of clinical workflows
- Comprehensive follow-up of tasks at hand and assigned
- Outstanding communication skills within, and external to, the Clinical Department
- Ability to work independent of given framework: projects return completed without having to reinterpret or additionally edit data
- Capable to managing internal databases: Can track and execute changes necessary within Clinical Dashboard necessary to maintain data integrity
- Managerial skillset: can objectively review calls and patient cases for quality and accuracy, communicates corrections effectively
- Can identify and communicate areas of their job/team that may need improvement or that are “pain points” in daily work
CORE COMPETENCIES
Ensures Accountability - Holding self and others accountable to meet commitments
Action Oriented - Taking on a new opportunities and tough challenges with a sense of urgency, high energy, and enthusiasm.
Customer Focus - Building strong customer relationships and delivering customer - centric solutions.
Interpersonal Savvy - Relating openly and comfortably with diverse groups of people.
Nimble Learning - Actively learning through experimentation when tackling new problems using both successes and failures as learning fodder.
Instills Trust - Gaining the confidence and trust of others through honesty, integrity, and authenticity.
QUALIFICATIONS
- Excellent verbal and written communication skills
- Ability to handle multiple priorities
- Proficient in Microsoft Office, especially Excel
EDUCATION and/or EXPERIENCE
- Previous retail pharmacy experience preferred
- Working knowledge of managed care pharmacy, preferred
- Working Knowledge of a PBM, preferred
CERTIFICATES, LICENSES, REGISTRATIONS
- Clinical Pharmacy Technician Certification (CPhT)
