Pharmacy Technician, Prior Auth, Remote

Molina Healthcare•Long Beach, CA

2d•Remote

About The Position

Provides support for pharmacy technician activities and contributes to the overarching pharmacy strategy for optimization of medication-related healthcare outcomes and quality, cost-effective member care.

Requirements

At least 2 years pharmacy technician experience, or equivalent combination of relevant education and experience.
Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice.
Ability to abide by Molina policies.
Ability to maintain attendance to support required quality and quantity of work.
Ability to maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA).
Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.
Excellent verbal and written communication skills.
Microsoft Office suite (including Excel), and applicable software program(s) proficiency.

Responsibilities

Performs initial receipt and review of non-formulary or prior authorization requests against pharmacy plan approved criteria; requests additional information from providers as needed to properly evaluate requests.
Accurately enters approvals or denials of requests.
Facilitates prior authorization requests within established pharmacy policies and procedures.
Participates in the development/administration of pharmacy programs designed to enhance the utilization of targeted drugs and identification of cost-saving pharmacy practices.
Identifies and reports pharmacy departmental operational issues and resource needs to appropriate leadership.
Assists Molina member services, pharmacies, and health plan providers in resolving member prescription claims, prior authorizations, and pharmacy service access issues.
Articulates pharmacy management policies and procedures to pharmacy/health plan providers, Molina staff and others as needed.