Pharmacy Technician - Care Management

Mass General Brigham•Somerville, MA

15d•$20 - $28•Remote

About The Position

The Pharmacy Technician Specialist works under the direction of the Population Health Services Organization Clinical Pharmacy team and is responsible for ensuring timely medication access for patients enrolled in Care Management Programs, to improve adherence to treatment recommendations and prevent gaps in necessary pharmacotherapy.

Requirements

High school diploma or equivalent
Must be a registered Pharmacy Technician with the Massachusetts Board of Pharmacy and maintain Certified Pharmacy Technician (CPhT) certification through a nationally recognized organization
2+ years of experience in a retail pharmacy setting, with emphasis on resolving insurance issues
Knowledge of medical terminology, abbreviations, and basic drug knowledge required
Proficiency in Microsoft Office (Word, Excel, PowerPoint)
Must complete annual Continuing Education credits as required to maintain certification

Nice To Haves

Experience with Manufacturer Patient Assistance Programs preferred
Experience performing Medicare Part D analysis preferred
Strong understanding of Pharmacy Benefit Manager (PBM) programs and ability to resolve rejected claims related to prior authorizations, formulary status, eligibility, tier exceptions, etc.
Flexibility to accommodate patients’ immediate needs
Strong initiative and self-motivation with minimal supervision
Familiarity with medical and scientific terminology
Excellent analytical skills to interpret member-level data and prepare summary reports
Strong verbal and written communication skills, including ability to create presentation-ready materials
Excellent interpersonal skills
Strong organizational and time management skills
Ability to manage multiple tasks and workflows effectively
Ability to work collaboratively as an integral member of the pharmacy team

Responsibilities

Collaborate with the PHSO Pharmacy team and Care Management teams to provide pharmacy resources to patients supported in the Care Management programs.
Work with pharmacies and pharmacy benefit managers to support pharmacy benefits, including resolving rejected claims due to coverage issues such as prior authorizations, formulary status, eligibility, etc.
Assist with medication copay assistance programs, including federal/state and other programs/resources
Support blister packaging workflows, including coordination with pharmacies, providers, and care teams to facilitate medication synchronization, packaging enrollment, and ongoing maintenance of blister-packed regimens
Resolve insurance-related issues and assist patients with completing forms for financial assistance
Create and mail patient medication cards
Document notes in the electronic medical record and any other tracking documents.
Serve as a resource to the PHSO Pharmacy team for drug-related inquiries (formulary, tier, prior authorization, cost share)
Stay current with industry trends and regulatory changes in the pharmacy industry, particularly related to Pharmacy Benefit Management, and incorporate knowledge into daily work
Handle confidential information in compliance with HIPAA guidelines
Carry out duties and responsibilities as assigned by PHSO Pharmacist(s)
Provide a variety of administrative functions to support Care Management Programs
Participate in meetings as necessary
Analyze pharmacy utilization data
Participate in the development of educational materials for providers