Pharmacy Technician II - CarelonRx Call Center
About The Position
The Pharmacy Technician II will be responsible for the interpretation and data entry of moderately complex prescriptions, prior authorization processing, and troubleshooting adjudication issues. The Clinical Pharmacy Care Center (CPCC) is a clinical pharmacy call center that services Medicare, Medicaid, and the Commercial member populations. The members we reach out to have been identified as having gaps in care. Our goal is to close those gaps through education and assistance. CarelonRx is a proud member of the Elevance Health family of companies. CarelonRx pairs a strong, clinical-first lens with deep pharmacy expertise to create solutions that improve outcomes, control costs, and enhance each member’s health.
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 and 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.
- For the CPCC business area a current Pharmacy Tech license and certification is required.
Nice To Haves
- Experience communicating with and supporting Medicare members preferred.
- Call center experience with high call volumes preferred.
- Experience in discussing medication adherence preferred.
- Proficient in computer systems and multitasking preferred.
- Patient care experience 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.
Benefits
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical
- dental
- vision
- short and long term disability benefits
- 401(k) +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
