Pharmacy Technician II

CareSource•Indiana WFH, IN

1d•$35,900 - $57,300

About The Position

The Pharmacy Technician II is responsible for entering and reviewing submitted authorization requests, assisting providers and pharmacies, and resolving escalations received in the pharmacy department. The role reviews traditional and specialty medication prior authorization requests for members’ pharmacy benefits, communicates with provider offices, places appropriate prior authorizations in the relevant systems, and routes requests requiring pharmacist review. The technician also answers inquiries about prescription coverage and formulary issues, troubleshoots pharmacy concerns, and supports Case Managers and Member and Provider Services with pharmacy issues, overrides, and questions. The position requires timely responses to inquiries submitted by fax, email, and electronic prior authorization channels, in keeping with state-mandated time periods. The technician documents telephone interactions, monitors workload aging, maintains knowledge of processes across markets, follows departmental and company policies, and may participate in special projects or perform other duties as requested. The role is based in a general office environment and may require sitting or standing for extended periods. Scheduling may include any shift between 7 a.m. and 9 p.m., as well as weekends and overtime as needed.

Requirements

High school diploma or equivalent years of relevant work experience.
Computer proficiency in a Windows environment.
Beginner-level Microsoft Word, Outlook, and Excel skills.
Typing speed of 40 words per minute.
Professional telephone communication skills and proper phone etiquette.
Familiarity with medical terminology, medication names, and the healthcare field.
Excellent communication skills when speaking with provider offices and pharmacies.
Ability to work independently and as part of a team.
Ability to train or teach new employees within the department.
Attention to detail, critical listening and thinking skills, and sound decision-making and problem-solving skills.
Proper grammar usage and time-management skills.
Customer-service orientation.
Knowledge of Medicaid and Marketplace.
Leadership experience and skills.
Ability to acquire state registration in multiple states, as required.
Flexibility to work any shift between 7 a.m. and 9 p.m., and weekends and overtime as needed.

Nice To Haves

Three years of retail pharmacy or hospital pharmacy experience.
One year of managed care prior authorization experience.
Pharmacy Technician Certification.

Responsibilities

Review traditional and specialty medication prior authorization requests for members’ pharmacy benefits submitted by providers.
Send fax communications to providers when necessary and follow up with provider offices when faxes fail.
Educate CareSource providers about resources outlining formulary alternatives.
Enter prior authorizations in the relevant system when approval is appropriate.
Initiate routing of prior authorizations that require pharmacist review.
Answer provider calls about prior authorization requests, prescription coverage, and formulary issues in a timely manner.
Make outbound calls to obtain information from providers and pharmacies.
Document all telephone interactions in the appropriate systems.
Respond to inquiries and submissions received by fax, email, and electronic prior authorization within state-mandated periods.
Participate in special projects as requested by the management team.
Answer calls and troubleshoot issues from retail and specialty pharmacies.
Assist Case Managers and Member and Provider Services with pharmacy issues, overrides, and questions.
Monitor workload aging and respond with an appropriate sense of urgency.
Maintain knowledge of processes and procedures for faxes and calls across all markets.
Adhere to departmental and company policies and procedures.
Perform other job duties as requested.