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HourlyPosition Purpose: Track and triage all coverage determination requests for prior authorizations and Medicare Part D recipients
Track and triage coverage determination requests submitted from providers and determine if a pharmacist review is required
Obtain verbal authorizations and request detailed clinical information from prescribers
Approve coverage determination requests based on defined criteria
Enter and document coverage determination request decision into the PBM system and notify providers and/or members
Respond to client inquiries regarding authorization approvals and PBM on-line applications
Refer coverage determination requests for specialty drugs to delegated vendor or client for processing
Contact providers for additional information to facilitate coverage determination reviews
Notify physicians, providers and members of coverage determination request decisions
Education/Experience: High school diploma or equivalent. 1+ years of retail, hospital or mail order pharmacy experience.License/Certification: Current state’s Pharmacy Technician license and National Certification.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.TITLE: Pharmacy Technician IILOCATION: Fresno, CaliforniaREQNUMBER: 1159283COMPANY: PharmacyPOSITION TYPE: Hourly
