Pharmacy Technician II (REMS Program)

Elevance Health•Lake Mary, FL

5d•Hybrid

About The Position

The Pharmacy Technician II is responsible for the interpretation and data entry of moderately complex prescriptions, prior authorization processing, and troubleshooting adjudication issues. This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. This position will be based at the following location: 3200 Lake Emma Rd, Ste 1000, Lake Mary, FL. BioPlus Specialty Pharmacy is a proud member of the Elevance Health family of companies. BioPlus offer consumers and providers an unparalleled level of service that’s easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer’s treatment journey.

Requirements

Requires H.S. diploma or equivalent and minimum of 2 years of pharmacy experience; or any combination of education and experience, which would provide an equivalent background.
Requires an active, professional license, if required by state law, State Pharmacy Technician Certification or National Certification based on applicable state(s) requirements, to practice as a Pharmacy Technician within the scope of practice in a state or territory of the United States.

Nice To Haves

Three or more years of pharmacy experience is strongly preferred.
Previous experience working in specialty pharmacies is highly preferred.
For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Responsibilities

Verifies member information and inputs data for the pharmacists.
Educates members on pharmacy based rules related to prescriptions and medication resources or assistance programs.
Processes prior authorization requests from physicians' offices and ensures compliance with Medicare requirements.
Informs relevant parties of all prior authorization determinations.
Provides resolution to grievances and appeals issues.
Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits.
Generates reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports.
Maintains record keeping of prior authorizations, rebates, and monthly reports.
Contacts healthcare providers offices to clarify prescription details, secure missing information, and resolve discrepancies that prevent order processing and/or obtain New prescription for the REMS patients.
Help deliver high-quality lifesaving pharmacy care for patients with complex or medical conditions.
Responsible for processing specialty prescriptions orders with accuracy, efficiency, professionalism, while ensuring compliance with regulatory requirements, and following internal standard operating procedures.