Pharmacy Technician II

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $35.9k - $57.3k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💊 Pharmacist

🦅 H1B Visa Sponsor

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CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• Review traditional and specialty medication prior authorization requests for members’ pharmacy benefits • Send fax communications to providers when necessary • Contact provider offices to follow up on failed faxes • Educate CareSource providers about resources outlining formulary alternatives • Place appropriate prior authorizations in prior authorization systems • Route prior authorizations requiring pharmacist review • Answer provider calls regarding prior authorization requests, prescription coverage, and formulary issues • Perform outbound calls to obtain information from providers and/or pharmacies • Document all telephonic interactions in appropriate systems • Ensure fax, email, ePA, and other inquiries and submissions are answered within state-mandated periods • Participate in special projects as needed • Answer calls and troubleshoot issues from retail and specialty pharmacies • Assist Case Managers and Member and Provider Services with pharmacy issues, overrides, and questions • Monitor workload aging and respond with appropriate urgency • Maintain knowledge of processes and procedures for all markets on faxes and phones • Adhere to departmental and company policies and procedures • Perform other duties as requested

🎯 Requirements

• High School Diploma or equivalent years relevant work experience is required • Three (3) years retail pharmacy or hospital pharmacy experience is preferred • One (1) year managed care prior authorization experience is preferred • Computer proficient with knowledge in a “Windows” environment • Beginner-level Microsoft Word, Outlook, and Excel • Must type 40 words per minute (WPM) • Professional-level telephone communication skills • Familiarity with medical terminology • Familiarity with medication names • Excellent communication skills when speaking to provider offices and pharmacies • Ability to work independently and within a team environment • Ability to train/teach new employees within the department • Attention to detail • Familiarity with the healthcare field • Knowledge of Medicaid/Marketplace • Critical listening and thinking skills • Proper grammar usage • Time management skills • Proper phone etiquette • Customer service orientation • Decision-making/problem-solving skills • Leadership experience and skills • Pharmacy Technician Certification is preferred • Ability to acquire state registration in multiple states, as required • Ability to work any shift between 7am and 9pm • Flexibility to work weekends and overtime, as needed

🏖️ Benefits

• Bonus tied to company and individual performance may be available • Comprehensive total rewards package • Employer investment in employee total well-being