Pharmacy Technician - Member Services

Curative HR LLC•Austin, TX

23h•Remote

About The Position

Curative wants to change the view on what a health plan can be. Born out of the pandemic, we created a health plan reinvented for a post-pandemic world that is built around whole-person affordable preventive care featuring more benefits. Curative is looking for a Pharmacy Technician with Member Services experience who is passionate about helping the company as we work to reinvent healthcare options. Candidates will be able to utilize their previous experience in Pharmacy Operations/Member Services experience by increasing satisfaction and retention by providing Curative health plan Members, patients, and providers with accurate, consistent, timely and meaningful information. They will provide support to Members’ while building rapport and collaborative relationships with current and prospective Members in accordance with compliance guidelines. This is a remote position with multiple shift options in a 24/7 call center.

Requirements

Excellent attendance is critical to success in this position
Internal candidates must have been in their current role for at least 6 months and have no performance or attendance actions in effect.
Excellent computer and phone skills, attention to detail, process and policy adherence
Excellent verbal and written communication skills.
Strong interpersonal skills.
Active listening skills to accurately respond to inquiries and requests.
Exceptional organizational skills, retention of policy and process a must
Intermediate skills minimum in google and microsoft office suite of products a must
Minimum 5 years experience in pharmacy or PBM operations
Associate's degree (A. A.) or equivalent from two-year college or technical school; or six months to one year related experience and/or training; or equivalent combination of education and experience.
Active PTCB certification required
Must have a quiet place, secure, with no distractions to perform duties for work from home
Must have password protected, stable internet access - stipend will be provided
Work location MUST be secure and private to maintain HIPAA compliance for work from home
While performing the duties of this Job, the employee is regularly required to sit; use hands to type, talk; and hear.
The employee is frequently required to reach with hands and arms.
Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
We also request, with the exception of emergencies, that you do not request any time off within the first 120 days of employment. Any request within the first 120 days if approved will be unpaid

Nice To Haves

Call Center Experience preferred but not required
Experience with Talkdesk (or other VOIP phone systems) preferred but not required
Experience with Helpscout (or other email ticket systems) preferred but not required
Experience with JUDI (or other prescription claims systems) preferred but not required
Experience with slack, gmail, zoom conference preferred but not required

Responsibilities

Monitoring for prescription claims rejections from 3rd party pharmacies
Outreach to members and providers with information regarding rejection and offering alternative options as applicable
Working with the Curative pharmacy prior authorization team discussing PA decisions with members and providers as needed
Evaluating extenuating requests and processing overrides as appropriate in the CAPRx JUDI system
Working with the Pharmacy team on non formulary drug alternatives for member and provider notification
Contact 3rd party pharmacies to reprocess claims, notify of drug alternatives, prior authorization status.
Correct claims and prior authorization request as needed
SME on pharmacy and drug benefits handling escalated contacts from members, providers, pharmacies, and member service team
Escalation support for after hours issues resolution as needed
Processing notifications to members services team for member outreach and status updates on prescription status
Working with leadership team on policy and process improvements
This position assumes and performs other duties, project management and data reporting as assigned
Work adhering to US regulatory and Quality System requirements (21 CFR 820, etc).

Benefits

Curative Health Plan (100% employer-covered medical premiums for you and 50% coverage for dependents on the base plan.)
$0 copays and $0 deductibles (with completion of our Baseline Visit )
Preventive and primary care built in
Mental health support (Rula, Televero, Two Chairs, Recovery Unplugged)
One-on-one care navigation
Chronic condition programs (diabetes, weight, hypertension)
Maternity and family planning support
24/7/365 Curative Telehealth
Pharmacy benefits
Comprehensive dental and vision coverage
Employer-provided life and disability coverage with additional supplemental options
Flexible spending accounts
Flexible work options: remote and in-person opportunities
Generous PTO policy plus 11 paid annual company holidays
401K for full-time employees
Generous Up to 8–12 weeks paid parental leave, based on role eligibility.