Pharmacy Technician II – Clinical Pharmacy Care Center
About The Position
The Pharmacy Technician II – Clinical Pharmacy Care Center works in CarelonRx’s clinical pharmacy call center, which serves Medicare, Medicaid, and commercial members identified as having gaps in care. The team helps close those gaps through education and assistance. The role interprets and enters moderately complex prescriptions, processes prior authorizations, and troubleshoots adjudication issues. The position is primarily virtual full-time, with in-person training required; candidates generally must live within commuting distance of an office unless an accommodation is granted. The scheduled shift is 12:00 p.m.–8:30 p.m. EST.
Requirements
- High school diploma or equivalent, and at least 2 years of pharmacy experience, or an equivalent combination of education and experience.
- An active professional license if required by state law, and state pharmacy technician certification or national certification as required by applicable state or territory requirements.
- For the CPCC business area, a current pharmacy technician license and certification are required.
Nice To Haves
- Experience communicating with and supporting Medicare members.
- Call center experience with high call volumes.
- Experience discussing medication adherence.
- Proficiency with computer systems and multitasking.
- Patient care experience.
- Strong oral, written, and interpersonal communication, problem-solving, facilitation, and analytical skills for URAC-accredited areas.
Responsibilities
- Verify member information and enter data for pharmacists.
- Educate members about pharmacy rules related to prescriptions and medication resources or assistance programs.
- Process prior authorization requests from physicians’ offices, ensure compliance with Medicare requirements, and inform relevant parties of determinations.
- Resolve grievance and appeal issues.
- Respond to inquiries from physicians, the sales team, and members concerning formularies and prescription benefits.
- Generate reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc topics.
- Maintain records of prior authorizations, rebates, and monthly reports.
- Interpret and enter moderately complex prescriptions and troubleshoot adjudication issues.
Benefits
- Merit increases
- Paid holidays
- Paid time off
- Incentive bonus programs, unless covered by a collective bargaining agreement
- Medical benefits
- Dental benefits
- Vision benefits
- Short- and long-term disability benefits
- 401(k) with matching
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
