Temporary- Managed Care Pharmacy Technician (Full Time)

Capital District Physicians' Health Plan • Latham, NY

127d

About The Position

Under the direct supervision of a licensed pharmacist, the Managed Care Pharmacy Technician (Pharmacy Tech) is responsible for administering CDPHP member and client-specific programs aimed at optimizing pharmacy benefits and the prescription process. This position will handle live calls to members as well as physicians and pharmacists, to provide information regarding pharmacy benefits, formulary coverage and CDPHP initiatives. The pharmacy tech will support initiatives including prior authorization work under the guidance of a licensed pharmacist. The pharmacy tech is responsible for implementing and monitoring the technical aspects of pharmacy benefits including the processing of medical exception requests using approved clinical algorithms, advising on pharmacy matters from internal and external sources, as well as additional ad hoc project work which supports the pharmacy department. The pharmacy tech will participate in an on-call/holiday rotation along with a utilization management pharmacist to support Plan members in after hour pharmacy issues.

Requirements

• Certification as Pharmacy Technician (CPT) through the Pharmacy Technician Certification Board, or completion of CPT accredited program required.
• Minimum three (3) years of experience in a retail pharmacy or managed care pharmacy setting required, or minimum five (5) years of experience without a CPT or completion of CPT accredited program.
• Experience with pharmacy claims processing, PBM systems, pharmacy billing and payment required.
• Experience in pharmacy policy, procedures, pharmacy payment systems, pharmacy market references and pricing methods including therapeutic category knowledge required.
• Experience with Microsoft Office, including Word, Excel, Outlook and PowerPoint is required.
• Demonstrated knowledge of pharmaceuticals, therapeutic category, routes of administration, delivery systems.
• Demonstrated ability to work with system support customers as well as interfacing with IT personnel to solve problems.
• Demonstrated ability to pro-actively identify problems, as well as recommend and/or implement effective solutions.
• Must be detail-oriented with strong organizational skills, including the ability to coordinate workflow.
• Excellent verbal and written communication skills.
• Flexibility to adapt to a changing and fast-paced environment.
• Demonstrated ability to work with and maintain confidential information.
• Demonstrated ability to provide excellent customer service and develop relationships both internally and externally.
• Ability to cover rotating on-call responsibilities, as well as a late shift on Fridays.
• Ability to work additional hours as needed in order to meet turnaround time responsibilities.

Responsibilities

• Administer CDPHP member and client-specific programs aimed at optimizing pharmacy benefits and the prescription process.
• Handle live calls to members, physicians, and pharmacists regarding pharmacy benefits and formulary coverage.
• Support prior authorization work under the guidance of a licensed pharmacist.
• Implement and monitor the technical aspects of pharmacy benefits.
• Process medical exception requests using approved clinical algorithms.
• Advise on pharmacy matters from internal and external sources.
• Participate in ad hoc project work supporting the pharmacy department.
• Participate in an on-call/holiday rotation to support Plan members in after hour pharmacy issues.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Securities, Commodity Contracts, and Other Financial Investments and Related Activities
• Education Level: No Education Listed
• Number of Employees: 501-1,000 employees