Senior Certified Pharmacy Technician

🔥 21 minutes ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $33.5k - $47.9k / year

⏰ Full Time

🟠 Senior

💊 Pharmacist

🦅 H1B Visa Sponsor

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

💼 Consulting

📦 Logistics

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Consulting • Logistics • Healthcare Insurance

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• Provide advanced support to members, prescribers, and pharmacy providers through phone, fax, email, and web-based communication channels • Research and resolve complex pharmacy benefit inquiries, including pharmacy claims, claim rejections, formulary questions, benefit interpretation, and medication access issues • Support and coordinate prior authorization processes • Ensure pharmacy-related requests are handled accurately and within established guidelines • Serve as a subject matter expert for team members • Assist with escalated issues and share pharmacy and PBM knowledge • Support training and onboarding activities • Contribute to quality and process improvement initiatives • Meet established service, productivity, compliance, and customer experience standards

🎯 Requirements

• Active and current Certified Pharmacy Technician (CPhT) credential • Minimum of 2 years of call center experience, preferably in a healthcare or PBM environment • Minimum of 2 years of PBM experience, including knowledge of formulary management, pharmacy claims adjudication, and benefit interpretation • Strong knowledge of pharmacy claims processing and claim rejection resolution • Experience supporting or coordinating prior authorization decisions • Strong verbal and written communication skills • Computer proficiency • Attention to detail • Ability to work across multiple systems in a fast-paced, high-volume environment • Reliable high-speed internet connection • Private, quiet workspace suitable for handling confidential information • Compliance with company technology, information security, and HIPAA requirements • Successful completion of required virtual onboarding and training • Comfort with extended computer and headset use in a call center environment • Availability to work assigned shifts, including evenings, overnights, weekends, or holidays • Successful completion of a skills and competency assessment • Residence in an approved state for remote employment as defined by company policy

🏖️ Benefits

• Work flexibility • Learning and career development • Company-provided equipment • Generous, flexible vacation policy • 401(k) employer match • Comprehensive health benefits • Educational assistance • Leadership and technical development academies