Pharmacy Technician, Intermediate

Your Role

The Drug Utilization Review & Prior Auth team processes and reviews prior authorization requests from the MD’s office. The Pharmacy Technician, Intermediate will report to the Supervisor, Pharmacy Services Operations. In this role, you will work independently to review medication cases while adhering to insurance company guidelines and regulations. Responding to and resolving prior authorization inquiries through real-time communication channels and ensuring seamless communication within the team.

Your Work

In This Role, You Will:

• Coordinate, assist in and support implementation of procedures and guidelines for the prior drug authorization program for the outpatient Pharmacy Benefit
• Evaluate prior authorization requests based on medication policy and operational principles
• Provide drug usage history and other pertinent pharmacy benefit related inquiries to internal business partners to assist in case specific reviews and drug evaluations
• Participate in, evaluate, and maintain efficient workflow procedures
• Make outbound calls to MD’s office for additional information and reach out to Pharmacy to resolve claim issues

Your Knowledge and Experience

• Requires a California Certified Pharmacy Technician license
• Requires 2 years of pharmacy related experience and training, or equivalent combination of education and experience
• Requires basic job knowledge of systems and procedures obtained through prior work experience or education
• Experience with navigating through multiple programs is preferred
• Knowledge of brand and generic drugs
• Familiarity with major ICD 10 codes is preferred