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Pharmacy Technician – Prior Authorizations
Location
Florida
Posted
28 days ago
Salary
$17 - $28 / hour
Seniority
Senior
Job Description
Pharmacy Technician – Prior Authorizations
CVS Health
• takes in-bound calls from providers, pharmacies, members, etc. providing professional and courteous phone assistance • maintains complete, timely and accurate documentation of reviews • transfers all clinical questions, escalations and judgement calls to the pharmacist team • assist with outbound calls, reviewing and processing Prior Auth’s received via fax and ePA • monitoring and responding to inquiries via department mailboxes • complies with departmental, company, state, and federal requirements when processing all information to ensure accuracy of information • communication with other internal groups regarding determination status and results • identify and elevate clinical inquiries to the pharmacist team as appropriate.
Job Requirements
- Able to apply basic computer skills
- Knowledge of Microsoft Office Suite: Excel and Word required; Access, Outlook, PowerPoint, Visio preferable
- Keyboard skills essential
- Basic pharmaceutical knowledge pertaining to terminology, calculations, and protocols
- Must be able to multitask and utilize multiple system applications simultaneously
- Must be able to utilize available resources independently and provide high quality work
- Must be able to absorb presented information, display motivation, seek development and problem solve
- Ability to adapt and change with workflow and shifting priorities
- Must possess excellent written, verbal, grammar, and listening communication skills
- Must be able to deal with a diverse customer base (internal and external) in a friendly and confident manner
- Ability to maintain confidentiality of PHI (Protected Healthcare Information).
Benefits
- medical, dental, and vision coverage
- paid time off
- retirement savings options
- wellness programs
- comprehensive benefits package designed to support physical, emotional, and financial well-being
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• Responsible for the clinical evaluation and determination of client UM requests. • Accountable for direct consultation with health care providers concerning non-formulary and clinical product coverage issues. • Collaborate with team members to promote consistency of clinical decisions across the pharmacist team. • Other duties as assigned.
• Evaluate comparative effectiveness reviews for formulary management opportunities • Present comparative effectiveness data and resulting formulary recommendations at client meetings • Generate formulary change order forms via GPI coding • Analyze pharmacy claims data for savings opportunities • Assist with prioritization and design of comparative effectiveness questions, incorporating client priorities, trends in claims data, new to market drugs, etc. • Manage medication related patient concerns with compassion and accountability • Work with prescribers to resolve patient medication concerns • Develop Prior Authorization criteria based on comparative effectiveness data • Support Prior Authorization adjudication • Act as a drug information resource/SME for the client team as they handle client requests and questions
Role Description This position is located within the Veterans Affairs VISN 12 Pharmacy Clinical Contact Center. The certified GS-10 Pharmacy Technician Supervisor is responsible for the supervision of all Pharmacy non-pharmacist technical staff and volunteers. Major Duties: - Develop the work schedule, plan and grant leave and rotate duties of the pharmacy technician staff. - Continuously analyze and reassess priorities, redirecting staff to assure that workload demands are accomplished in the most effective, efficient, and economic manner possible. - Assist with the development of performance standards that are realistic, challenging, and supporting the organizational mission, vision, and goals. - Responsible for ensuring all employees meet performance standards and competencies. - Assist the Chief of Pharmacy in interviewing and selecting new employees and candidates for promotion and/or reassignment. - Conduct technician meetings to assure proper updates of departmental and local pharmacy communications. - Assist in the development of policies and procedures and participate in departmental goal planning and quality improvement activities. - Will perform any duties of a pharmacy technician when the needs of the service require. Qualifications - Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. - United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. - Education or Experience: - (1) None required. - (2) For all grade levels and positions that accept both education and experience to qualify, equivalent combinations of qualifying education and experience that total at least 100% are qualifying. - Certification: For positions above the full performance level, the employee must pass a national certification exam and hold an active national certification through either: - (1) Pharmacy Technician Certification Board (PTCB), Certified Pharmacy Technician (CPhT). - (2) National Healthcareer Association (NHA), Certified Pharmacy Technician (ExCPT). Requirements - Pharmacy Technician GS-10 Experience: In addition to meeting the basic requirements, one year of progressively complex experience equivalent to the lower grade level. - Certification: For positions above the full performance level, the employee must pass a national certification exam and hold an active national certification through either: - (a) PTCB as a CPhT. - (b) NHA as a ExCPT. - Knowledge, Skills and Abilities (KSAs): - (a) Ability to analyze data for performance improvement projects, workload analysis and statistical reports. - (b) Ability to prepare for and maintain special accreditations, inspections and reviews (e.g., The Joint Commission, Office of Inspector General, American Society of Health System Pharmacists, controlled substances inspections). - (c) Ability to solve problems and implement corrective actions to maximize outcomes in their program area. - Additional Knowledge, Skills and Abilities (KSAs): - (A) Skill in managing multiple, diverse programs. - (B) Ability to contribute planning, execution and evaluation of program goals, objectives and priorities to resolve service issues. - (C) Ability to perform the full range of supervisory duties, which includes responsibility for assignment of work, performance evaluations, selection of staff, recommendation of awards, advancements and disciplinary actions. Company Description



