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Clinical Pharmacy Technician I - Full-time / Part-time
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Maryland Heights, MO, 63043 Maryland Heights, Missouri |
About this job
Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.
ESSENTIAL FUNCTIONS:
- Determines appropriateness for medications. Communicates decision to physicians, physician?s office staff, medical management staff and/or pharmacists.
- Researches, resolves and documents prior authorization outcomes in pharmacy system.
- Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician?s office staff, medical management staff and/or pharmacists.
- Escalates requests to Pharmacist when request requires extensive clinical review or denial.
- Researches, resolves and documents physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management.
- Performs other duties as required.
ESSENTIAL FUNCTIONS:
- Determines appropriateness for medications. Communicates decision to physicians, physician?s office staff, medical management staff and/or pharmacists.
- Researches, resolves and documents prior authorization outcomes in pharmacy system.
- Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician?s office staff, medical management staff and/or pharmacists.
- Escalates requests to Pharmacist when request requires extensive clinical review or denial.
- Researches, resolves and documents physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management.
- Performs other duties as required.
General Job Information
Title
Clinical Pharmacy Technician IGrade
16Job Family
Call_Contact Center_PhCountry
United States of AmericaFLSA Status
United States of America (Non-Exempt)Recruiting Start Date
9/27/2017Date Requisition Created
9/27/2017Minimum Qualifications
Education
GED (Required), High School (Required)License and Certifications - Required
CPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - PharmacyLicense and Certifications - Preferred
Other Job Requirements
Responsibilities
CPT - Certification/licensure in accordance with state requirements. In the states of Florida and Michigan, license registration with the Board of Pharmacy is required without exception.PTCB - Certification or the ability to obtain PTCB Certification within one year of hire. Employees in states which require a Pharmacy Technician certification exam may substitute state certification for the PTCB. 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. Ability to identify and trouble-shoot problematic issues., Minimum of 6 months dispensing or retail experience required, or equivalent internal training will be substituted.Competencies
Language(s)
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled