Pharmacy Technician - Onsite (Based in or Near Salt Lake, UT)

Prime Therapeutics•Salt Lake, UT

8d•Onsite

About The Position

Prime Therapeutics (Prime) is a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. This role evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria. The technician is responsible for supporting both front-end and back-end operations, including order fulfillment, packaging, shipping, and ensuring accurate and timely processing of products. This position is NOT a remote position and will require the employee to be ONSITE.

Requirements

High school diploma from an accredited school or equivalent GED
CPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy
Must be eligible to work in the United States without the need for work visa or residency sponsorship
Must have an active pharmacy technician licensure or registration in accordance with state requirements.
If state does not require an exam for licensure/registration, must possess both active pharmacy technician licensure or registration in accordance with state requirements AND an active national certification (e.g., PTCB or ExCPT).
In states that do not require licensure or registration, must have an active national certification (e.g., PTCB or ExCPT).
Active Pharmacist license supersedes requirement for CPT and/or PTCB.
Minimum of 6 months dispensing or retail experience required, or equivalent internal training will be substituted.
Ability to identify and trouble-shoot problematic issues.

Nice To Haves

Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.
In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).
Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.
Excellent written and verbal communication skills.
Ability to follow clinical criteria and instructions to approve prior authorization requests.
At least 1 year of experience in a pharmacy or specialty pharmacy setting

Responsibilities

Determines appropriateness for medications.
Communicates decision to physicians, physician's office staff, medical management staff and/or pharmacists.
Researches, resolves and documents prior authorization outcomes in pharmacy system.
Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician's office staff, medical management staff and/or pharmacists.
Escalates requests to Pharmacist when request requires extensive clinical review or denial.
Researches, resolves and documents physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management.
Performs other duties as required.
Clinically reviews coverage determinations with attention to detail, for medications via Fax.
Communicates decision to physicians, physician's office staff, medical management staff and/or pharmacists within SLA (service level agreement) guidelines.
Efficiently multi-tasks and monitors several queues and assignments.
Adapts to team requirements as business needs change (e.g., fax work, pending queues, oral notifications, and failed faxes).