Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.Job Posting TitleClinical Pharmacy Technician IIJob Description SummaryEvaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.Job Description
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.
Monitors telephone system to ensure adequate staffing to maintain client services levels.
Assesses training needs within the team. Serves as a training resource, mentor and coach to others. Identifies and shares best practices.
Demonstrates, advocates and reinforces a positive team environment.
Other duties as assigned.
Responsibilities
Must have an active pharmacy technician licensure or registration in accordance with state requirements.
If state does not require an exam for licensure/registration, must possess both active pharmacy technician licensure or registration in accordance with state requirements AND an active national certification (e.g., PTCB or ExCPT).
In states that do not require licensure or registration, must have an active national certification (e.g., PTCB or ExCPT).
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 2 years dispensing or retail experience required, or equivalent internal training will be substituted.
Ability to identify and trouble-shoot problematic issues.
Work ExperienceWork Experience - Required:PharmacyWork Experience - Preferred:EducationEducation - Required:GED, High SchoolEducation - Preferred:CertificationsCertifications - Required:CPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy - PharmacyCertifications - Preferred:To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page (https://www.primetherapeutics.com/benefits) and click on the "Benefits at a glance" button for more detail.Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law.We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.Prime Therapeutics LLC is a Tobacco-Free Workplace employer.Positions will be posted for a minimum of five consecutive workdays.Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information, veteran status, marital status, pregnancy or related condition (including breastfeeding), expecting or parents-to-be, or any other basis protected by law.We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.Prime Therapeutics LLC is a Tobacco-Free Workplace employer.If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email Careers@primetherapeutics.com.
