Pharmacy Technician II - BioPlus Specialty Pharmacy
About The Position
BioPlus Specialty Pharmacy is now part of CarelonRx (formerly IngenioRx), and a proud member of the Elevance Health family of companies. Together, CarelonRx and BioPlus offer consumers and providers an unparalleled level of service that’s easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer’s treatment journey. The Pharmacy Technician II is responsible for the interpretation and data entry of moderately complex prescriptions, prior authorization processing, and troubleshooting adjudication issues. How you will make an impact: 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.
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 or 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 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
- We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
