Pharmacy Technician II – Clinical Pharmacy Care Center
Core
Interpret and data entry moderately complex prescriptions, process prior authorizations, and troubleshoot adjudication issues for Medicare, Medicaid, and Commercial members.
Role type
Pharmacy Technician II (Clinical Pharmacy Care Center)
Builds
Prior authorization workflows and member care resolution
Domain
Health insurance / Pharmacy benefits administration
Deliverable
client delivery
Required skills
Prescription interpretation, data entry, prior authorization processing, grievance and appeals resolution, formulary knowledge, medication adherence education, outreach
Preferred skills
Call center experience
Technologies
None explicitly stated
Responsibilities
Verify member information and input data for pharmacists; Process prior authorization requests from physicians' offices; Provide resolution to grievances and appeals issues; Respond to inquiries from physicians, sales team, and members; Educate members about prescriptions and medication resources; Assist members with scheduling preventive tests and screenings; Make outreach to members or providers to close care gaps
Seniority
Non-Management Non-Exempt