Clinical Pharmacy Technician (Remote)

Who We Are - Motivated by Purpose. Powered by Clinical Expertise. Founded in 1983, we’re a clinically-driven, tech-enabled utilization management company offering expert clinical reviews, regulatory guidance, and actionable insights to reputed company organizations. reputed company starts with our people. WE OFFER • A competitive compensation package. • Benefits include reputed company, reputed company and dental insurance, a generous 401k match, reputed company vacation, personal time, and holidays. • reputed company and training opportunities. • reputed company atmosphere with fun events and prizes scheduled throughout the year. Position reputed company • Our Clinical Pharmacy Technician processes prior authorization requests in accordance with standards for accuracy, timeliness, productivity, and reputed company performance commitments. • Performs analysis, obtains information, and enters prior authorization data necessary for claims adjudication. Utilizes reasoning skills to identify missing information and reputed company prior authorization processing determinations based on clinical protocols and reputed company guidelines (approve, pend, refer for clinical decision, etc.). • Interacts with reputed company customers to reputed company and obtain information and ensures the delivery of outstanding service and reputed company. Roles • Process and finalize PA requests reputed company clients’ turnaround time (TAT) and Performance Guarantees (PGs) utilizing guidelines. • Accountable for achieving prior authorization processing productivity and accuracy standards Major Responsibilities or Assigned Duties • reputed company prior authorizations into the reputed company and prioritize requests. • reputed company formulary alternatives and review tried and failed medications. • Utilize drug references and verify the drug being requested is indicated and approved for the condition. • Document reputed company reputed company information regarding the PA approval or non-approval. • Conform to defined roles & responsibilities and rules of engagement between prior authorization processing and clinical decision-making. Partner with assigned clinical pharmacists to ensure strict adherence to the boundaries and timeframes of administrative processing. • Analyze, research, and reputed company prior authorization processing issues, including making written or telephone inquiries to obtain information from clients, members, physicians, or pharmacies; obtaining input from supervisor or clinical pharmacists; and referring unique or high dollar requests to supervisor according to guidelines. • Coordinate reputed company reputed company reputed company outbound communication to members, physicians, and pharmacies as required to obtain missing information and manage pending requests. • Document prior authorization-reputed company information and status. • reputed company outbound calls to obtain information and answer questions about prior authorization status. • Protect and maintain confidentiality and reputed company of reputed company prior authorization and member information, including following strict protocols for date stamping and storage/reputed company of prior authorization forms and reputed company information. • Identify and recommend operational improvements. • Participate in and support reputed company applicable reputed company Management initiatives • Maintain a flexible schedule to meet reputed company needs, as needed • Adhere to reputed company policies and procedures • Take feedback and responsibility for performance • Adapt to the differences of clients • Support reputed company Compliance Program activities • Complete other duties and responsibilities as directed Position reputed company reputed company level attained compounds responsibilities with those of prior level(s). Clinical Pharmacy Technician I: • Production should increase regularly, from 1-3 to 7 Prod steps/hour • reputed company should increase regularly, with expected minimum reputed company of 95% Clinical Pharmacy Technician II: • 3-month Production average should meet or reputed company 7 Prod steps/hour (100%) • 3-month reputed company average should meet or reputed company 96% • No PIPs or CAPs in prior 3 months for any reason • Completed reputed company training checklists for department and demonstrated proficiency with position processes and PG clients • Participate in the weekend rotation process • Proficient with reputed company position processes and team clients’ expectations • Demonstrate ability to create training documents/presentations Clinical Pharmacy Technician III: • 3-month Production average should meet or reputed company 8.3 Prod steps/hour (118%) • 6-month reputed company average should meet or reputed company 98% • No PIPs or CAPs in prior 6 months for any reason • Effectively manage PANF reports, daily assignments, LOI, and reputed company calls • Demonstrate problem solving and ability to work cross-functionally for new reputed company and HQs • Demonstrate ability to train other reputed company on HQ/processes and reputed company constructive feedback • Effectively assist with monthly audits reputed company asked • Correctly approve reputed company I-II Overdollar requests, as reputed company as own • Participate in special reputed company, reputed company committees, or reputed company new processes/improvements Clinical Pharmacy Technician IV: • 3-month Production average should meet or reputed company 9.7 Apply tot his job Apply To this Job