Pharmacy Technician – Health Plan

🔥 0 minutes ago

🎸 Tennessee – Remote

🎸 Tennessee – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

💊 Pharmacist

🚫👨‍🎓 No degree required

👻 Ghost score 10%

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American Health Partners

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1976

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

American Health Partners is a healthcare organization focused on improving access to and coordination of high-quality care through a continuum of services tailored to institutional and special-needs populations. The company operates institutional special needs health plans and provides specialized care coordination, geriatric inpatient and acute psychiatric care, and pharmacy services for long-term-care facilities, supported by an owned/affiliated network of locations and thousands of contracted providers. American Health Partners emphasizes convenient, preventive care to reduce costly hospital stays and improve patient outcomes and quality of life.

📋 Description

• Review daily point-of-service (POS) pharmacy claims, resolve actionable items, track, and provide reporting • Serve as a liaison with Enrollment Department to assure appropriate member eligibility processing • Work with the PBM management team to ascertain the highest level of Pharmacy Benefit Manager performance • Recognize formulary requirements: prior authorization (PA), Step Therapy (ST), Quantity Limit (QL), and understand NCPDP reject codes • Communicate with pharmacies, nursing homes, and providers • Coordinate clinical reporting • Follow up and solve open items in a timely manner • Work on special projects and business initiatives as assigned • Perform other duties as assigned

🎯 Requirements

• High school diploma or equivalent • Minimum of 2 years as a Pharmacy technician, long term care, or health plan experience • Experience in planning and implementation • Pharmacy Technician certification preferred • Proficient with Microsoft Suite applications • Ability to navigate multiple systems • Strong analytical skills • Proficient communication and presentation skills • Adhere to Centers of Medicare and Medicaid Services (CMS) regulations and compliance requirements • Successful completion of required training • Must perform each essential function satisfactorily, with or without a reasonable accommodation

🏖️ Benefits

• Affordable Medical/Dental/Vision insurance options • Generous paid time-off program and paid holidays for full time staff • TeleDoc 24/7/365 access to doctors • Optional short- and long-term disability plans • Employee Assistance Plan (EAP) • 401K retirement accounts with company match • Employee Referral Bonus Program • Reasonable accommodations for qualified individuals with disabilities