Pharmacy Technician II – Clinical Pharmacy Care Center
About The Position
The Pharmacy Technician II – Clinical Pharmacy Care Center supports the Clinical Pharmacy Care Center (CPCC), a clinical pharmacy call center serving Medicare, Medicaid, and Commercial members identified as having gaps in care. The center’s goal is to close those gaps through education and assistance. The role interprets and enters moderately complex prescriptions, processes prior authorizations, and troubleshoots adjudication issues. It is primarily virtual full-time, with required in-person training sessions; candidates must be within reasonable commuting distance of a posting location unless an accommodation is granted as required by law. The schedule is 12:00 p.m. to 8:30 p.m. EST.
Requirements
- High school diploma or equivalent, and at least 2 years of pharmacy experience; alternatively, an equivalent combination of education and experience.
- An active professional license, when required by state law, and state pharmacy technician certification or national certification according to 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 handling high call volumes.
- Experience discussing medication adherence.
- Proficiency with computer systems and multitasking.
- Patient care experience.
- For URAC-accredited areas: strong oral, written, and interpersonal communication, problem-solving, facilitation, and analytical skills.
Responsibilities
- Verify member information and enter data for pharmacists.
- Educate members about pharmacy-based prescription rules, medication resources, and 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 physician, sales team, and member inquiries about formularies and prescription benefits.
- Generate reports related 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 insurance
- Vision insurance
- Short- and long-term disability benefits
- 401(k) with company match
- 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
