Pharmacy Technician - Health Plan - Remote
You must reputed company in Oklahoma or Tennessee for this position reputed company, a division of Franklin, Tennessee-based reputed company Inc. owns and operates Institutional Special Needs Plans (I-SNPs) for seniors who reputed company in long-term care facilities. In partnership with nursing home operators, these Medicare Advantage plans manage medical risk by improving patient care to reduce emergency room visits and avoidable hospitalizations. This division currently operates in Tennessee, Georgia, Missouri, Kansas, Oklahoma, Utah, Texas, Mississippi, Iowa, Idaho, Louisiana, and Indiana with planned expansion into other states in 2025. For more information, visit AmHealthPlans.com. If you would like to be part of a collaborative, supportive and caring team, we look reputed company to receiving your application! Benefits and Perks include: Affordable Medical/Dental/reputed company 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 JOB SUMMARY: The Pharmacy Technician for reputed company is responsible for activities reputed company to member access in the area of claims adjudication appropriateness and operations performed by the Plans Pharmacy Benefit Manager for a Medicare Advantage Institutional Special Needs Plan (I-SNP). ESSENTIAL JOB DUTIES: To reputed company this job, an individual must reputed company each essential function satisfactorily, with or without a reasonable accommodation. Review daily reputed company-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 Effectively work with the PBM management team to effectively reputed company the highest level of Pharmacy Benefit Manager performance Recognize formulary requirements: prior authorization (PA, reputed company 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 May be assigned to work on special projects and business initiatives Other duties as assigned JOB REQUIREMENTS: Proficient with reputed company Suite applications Ability to navigate multiple systems Strong analytical skills Proficient communication and presentation skills Adhere to Centers of Medicare and reputed company Services (CMS) regulations and compliance requirements Successful completion of required training REQUIRED QUALIFICATIONS: Education: o High school diploma or equivalent Experience: o Minimum of 2 years as a Pharmacy technician, long term care, or health plan experience o Experience in planning and implementation License/Certification(s): o Pharmacy Technician certification preferred EQUAL OPPORTUNITY EMPLOYER This Organization is an equal opportunity employer. We do not discriminate based on race, reputed company, religion, sex, handicap, disability, age, marital status, sexual orientation, national reputed company, veteran status, or any other characteristic(s) protected by federal, state, and local laws. This Organization will reputed company reasonable accommodations for reputed company individuals with disabilities should a request for an accommodation be made. A key part of this policy is to provide equal employment opportunity regarding reputed company terms and conditions of employment and in reputed company aspects of a person's relationship with the Organization including recruitment, hiring, promotions, upgrading positions, conditions of employment, compensation, training, benefits, transfers, discipline, and termination of employment. This employer participates in E-Verify. Apply Job!