Utilization Management Pharmacy Technician

Sutter Health•Sacramento, CA

1d•$46 - $65•Hybrid

About The Position

Provides the manager performance monitoring, resolve pharmacy and medication related issues for members, review the practices and procedures , and provide pharmacy, benefit and compliance related expertise to Sutter. Works on a number of critical initiatives including: Audit vendor selection and audit, on site evaluation, clinical programs, like narcotic drug use review and adherence, specialty product channeling, compliance with regulations, cost analysis with possible rate negotiations and special studies. Is responsible for the coordination of services and cost effective management of pharmaceutical resources to meet individual members' health care needs and promote positive health care outcomes. The responsibilities include assessment, coordination, planning, monitoring and evaluation of multiple environments. Acts as a member advocate and liaison between providers, members, pharmacies and Sutter Health to seamlessly integrate services.

Requirements

Graduate of an accredited pharmacy technician program.
PHARMC-Certified Pharmacy Technician
2 years recent relevant experience
Knowledge of data fields required by National Council for Prescription Drug Programs (NCPDP).
Ability at running ad hoc reports from pharmacy claims data with strong PC skills including PowerPoint, Access, Outlook, Excel and Word.
Knowledge of Health Insurance Portability and Accountability Act (HIPAA), Health Care Reform, Business Code of Ethics and government regulated programs.
Ability to work collaboratively, prioritize functions, problem solve, and anticipate upcoming issues for the executives.

Responsibilities

Provides the manager performance monitoring
Resolve pharmacy and medication related issues for members
Review the practices and procedures
Provide pharmacy, benefit and compliance related expertise to Sutter
Audit vendor selection and audit
On site evaluation
Clinical programs, like narcotic drug use review and adherence
Specialty product channeling
Compliance with regulations
Cost analysis with possible rate negotiations and special studies
Coordination of services and cost effective management of pharmaceutical resources to meet individual members' health care needs and promote positive health care outcomes
Assessment, coordination, planning, monitoring and evaluation of multiple environments
Acts as a member advocate and liaison between providers, members, pharmacies and Sutter Health to seamlessly integrate services