Clinical Pharmacy Technician Sr

Prime Therapeutics•Home, WV

1d•$19 - $29

About The Position

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Clinical Pharmacy Technician Sr Job Description Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.

Requirements

GED High School Required
CPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy
2+ years relevant work experience
Must be eligible to work in the United States without the need for work visa or residency sponsorship
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).
Minimum of 2 years dispensing or retail experience required, or equivalent internal training will be substituted.
Ability to identify and trouble-shoot problematic issues.

Nice To Haves

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.

Responsibilities

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.