Pharmacy Technician II

PacificSource Health Plans • Springfield, OR

12d • $39,808 - $63,693 • Hybrid

About The Position

Coordinate application of pharmacy services and benefits as an integral contributor on the pharmacy team. Handle pharmacy-related inquiries and communicate benefit determinations. Provide pharmacy services helpdesk support to pharmacies, providers, and members. Perform pharmacy authorization and claim processing services.

Requirements

• Minimum two years Pharmacy Technician experience.
• Demonstrated ability to work efficiently and effectively with a high attention to detail.
• Minimum high school diploma or equivalent.
• Unrestricted pharmacy technician license by the Board of Pharmacy and previously passed National Pharmacy Technician certification exam required.
• Maintain continuing education requirements for license renewal.
• Good understanding of Medical Terminology required.
• Familiarity of CPT/ICD-10 codes, home infusion therapies, and specialty medications helpful.
• Microsoft Office products including Word, Excel, and Outlook.
• Ability to work under time sensitive deadlines.
• Ability to prioritize responsibilities, diplomatically, handle demanding situations and manage workload with direct supervision.
• Demonstrate organizational and time management skills.
• Ability to understand and interpret Federal and State specific regulatory requirements helpful.
• Ability to communicate effectively across all levels of the business on a consistent basis.

Responsibilities

• Act as principal contact regarding drug authorizations and system overrides.
• Help to resolve pharmacy services and benefits inquiries through skillful knowledge of the pharmacy claims, medical claims, and utilization management platforms.
• Initiate clinical review and decision-making of authorization requests under the guidance of clinical pharmacists.
• Effectively communicate and collaborate in a clear and concise manner to internal and external partners, including translating clinical and technical industry jargon to appropriate audiences.
• Function as liaison with pharmacy benefit manager, pharmacies, physicians, and others in order to apply benefits, and assist with pharmacy benefit determinations.
• Consult with clinical pharmacists and other staff in determining coverage for pharmacy-related services and pharmaceuticals.
• Prepare and process member-submitted pharmacy claims in the pharmacy benefit manager’s claims processing system.
• Ensure all coverage determinations are processed in a timely and accurate manner, consistent with Commercial, Medicare & Medicaid regulatory requirements and department policies.
• Serve as primary resource to members and providers for pharmacy questions related to the health plan and in navigating through the health systems.
• Provide support and maintenance for department communication tools (ie. Sharepoint), as applicable.
• Assist Pharmacy Services Leadership to ensure compliance with all rules and regulations as applicable.
• Meet department and company performance and attendance expectations.
• Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
• Perform other duties as assigned

Benefits

• Flexible telecommute policy
• medical
• vision
• dental insurance
• incentive program
• paid time off and holidays
• 401(k) plan
• volunteer opportunities
• tuition reimbursement and training
• life insurance
• flexible spending account

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED