Complete prior authorizations and refill authorizations for ambulatory care clinics across the system.
Promote patient care, safety, and medication adherence through the processing and/or assistance of prior authorizations, refill authorizations, and patient assistance programs
Completes tasks in EMR as directed
Participate in teaching activities, including but not limited to, precept Pharmacy Technicians, Pharmacy Students, Pharmacists, and Nurses regarding refill authorizations, prior authorizations, and or patient assistance programs
Report directly to the pharmacist on service in the clinic and/or to other pharmacists while working
Responds to calls and questions in an efficient, effective, and professional manner
Serves as a pharmacy services representative in addition to valuable member of the healthcare team
ACT will assume additional duties as required by the pharmacy director, manager, and/or supervisor
Initiate and coordinate prior authorization requests in the electronic health record and/or external processing system (e.g. CoverMyMeds)
Act as a liaison between the Clinical Department and members, providers, pharmacies, and internal departments and respond to inquiries regarding status of prior authorization requests
Assist with internal and external reporting requests and summarize internal program statistics
Maintain prior authorization management solution, including:
a. Interpretation and application of prior authorization guideline revisions
b. Configuration and quality assurance of clinical criteria, decision scenarios, and other elements
c. Development and maintenance of notification templates in compliance with client plan language and other regulatory requirements
Compare prescription claims data against requested parameters and summarize/present results or recommendations
Utilize authorized physician protocol to process prescription refill requests in a timely manner and documents into EMR system
Conduct patient and pharmacy callbacks in a time efficient manner while maintaining proper phone etiquette
Handle intake of multiple phone lines using established scripts, protocols and service processes
Accurately track and enter calls using appropriate documentation, reporting, and database applications. Assist with maintaining department databases and resource tools
Coordinate administrative aspects of medication services pertaining to patient assistance programs (PAP)
Provides support necessary to facilitate the application and acquisition of free or reduced cost medications
Serves as a liaison between patients and clinic medical staff regarding eligibility, application procedures, submission of required documentation, and prescription of medications
Maintains comprehensive data base in conjunction with clinic leadership
High School Diploma or equivalent.
1 year in retail pharmacy or equivalent.
(BLS) BASIC LIFE SUPPORT course accredited by the American Heart Association (AHA) or American Red Cross (ARC) Upon Hire
(TSBP) REG PHARMACY TECNICIAN Registration with Texas State Board of Pharmacy (TSBP) as a Registered Technician or Pharmacist Intern Upon Hire
Work requires good organizational skills.
Basic computer skills, data entry, filing.
English (speaking, reading, writing). Good general health and stress coping ability. Moderate physical effort: prolonged standing/walking, occasional lifting/carrying (up to 25 lbs), reaching, bending, crouching, etc. OSHA Category III.
(PTCB-CPHT) CERTIFIED PHARMACY TECHNICIAN
PPO medical plan, available day one at no cost for full-time employee-only coverage
100% coverage for preventive healthcare-no copay
Paid Time Off, available day one
Retirement Programs through the Teacher Retirement System of Texas (TRS)
Paid Parental Leave Benefit
Wellness programs
Tuition Reimbursement
Public Service Loan Forgiveness (PSLF) Qualified Employer