Pharmacy Technician - Clinical Coordinator

HealthOne Alliance•Dalton, GA

21h

About The Position

The Pharmacy Technician – Clinical Coordinator is responsible for assisting members and providers with the navigation of the pharmacy and medical benefit as it relates to the acquisition and administration of prescription drugs and/or provider administered medications covered under the health plan, monitoring and producing data related to pharmacy claims, assisting with implementation, maintenance, and coordination of the pharmacy program. This position helps promote member and provider satisfaction by acting as a resource for pharmacy related requests and by providing ongoing navigation of all aspects of the pharmacy benefit.

Requirements

High School diploma or equivalent required
Pharmacy Technician Certification Board (PTCB) National Certification and/or National Healthcareer Association (NHA) Pharmacy Technician Certification
Must be registered (or willing to be registered) with the state of Georgia as a Pharmacy Technician
2-3 years’ required work experience as a Pharmacy Technician, preferably in a retail or managed care environment
Required experience in processing prescription claims
A basic understanding of common formulary management strategies, including formulary edits and restrictions (ie. quantity limits, tiered copays, etc.)
Familiarity with common pharmacy products, indications, and general costs (ie. Brand vs Generic drugs, Specialty vs non-specialty drugs)
Experience in medical pharmacy billing and coding (HCPCS, NDCs, Common Pharmacy related Procedure Codes, Place of Service)
Proficient in Microsoft Office applications with experience using Word, Excel, PowerPoint, and Outlook

Nice To Haves

Bachelor or associates degree preferred
1-year preferred work experience at a Managed Care Organization/Health Plan
Preferred experience in a reporting/analytic environment with experience specific to pharmacy data analysis and reporting

Responsibilities

Leverages multiple internal and external pharmacy software applications to assist with aggregating and analyzing pharmacy related data and pharmacy claim information
Seeks to improve member experience, streamline appropriate access to medications, and drive quality outcomes by collaborating with the Alliant Client Services department to address and resolve member and provider related pharmacy questions
Demonstrate critical thinking in order to support and resolve client concerns
Escalates pharmacy related concerns internally across multiple departments and externally with the PBM account team
Communicate clearly and effectively both in person and on the phone to a variety of audiences including members, member care providers, physicians, pharmacists and staff
Coordinates, organizes, and maintains detailed meeting notes, developments, and documents interactions with external pharmacy benefit vendors
Maintains regular and predictable attendance
Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice
Works to encourage and promote Company culture throughout the organization
Other duties as may be assigned