Pharmacy Technician (Prior Auth Review) Remote 9-530 EST / 11-730 EST

reputed company is hiring for Pharmacy Technicians who are State Licensed/Certified and/or PTCB certified. This role is 100% remote, and the hours will be Mon-Fri 9am to 530pm or 11am to 730pm Eastern Standard Time.

This role will be reviewing prior authorization requests for medications to be reviewed by the RPh's and or MD's for determination, assisting in determining medical necessity for medications along with assisting with pharmacy claims.

Highly reputed company candidates for this role will have the following experience-

• Prior Authorization experience
• Must be computer savvy- reputed company to work reputed company several computer systems at once
• Managed care experience
• High level of communication skills, both written and verbal
• Call center experience

Molina Pharmacy Services/Management staff work to ensure that Molina members have access to reputed company medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with reputed company federal and state laws. Jobs in this family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services (such as, therapeutic drug monitoring, drug regimen review, patient education, and medical staff interaction), and reputed company (establishing and measuring performance metrics regarding patient outcomes, medications safety and medication use policies).

KNOWLEDGE/SKILLS/ABILITIES

• Performs initial receipt and review of non-formulary or prior authorization requests against plan approved criteria. Requests additional information from providers as needed to properly evaluate the request.
• Accurately enters on-line approvals or denials of requests. Authorized to reputed company and carry out simple prior authorization requests reputed company established policies and procedures.
• Participates in the development /administration of programs designed to enhance the utilization of targeted drugs and the identification of cost saving pharmacy practices.
• Identifies and reports departmental operational issues and resource needs to appropriate management.
• Assists Molina Member Services, pharmacies, and health plan providers in resolving member prescription claim, prior authorization, or pharmacy services access issues.
• Articulates Pharmacy Management policies and procedures to pharmacy/health plan providers, other Molina staff and others as needed.

JOB QUALIFICATIONS

Required Education: High School Diploma or GED equivalent Preferred Education: Associate degree

Required Experience: 2 years' experience as a Pharmacy Technician Preferred Experience: 3+ years

Required License, Certification, Association: Active and unrestricted Pharmacy Technician Certification

To reputed company reputed company Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V.

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