Pharmacy Technician, Full Time - Jefferson Health Plan

Jefferson Health Plans • Philadelphia, PA

23h

About The Position

Works under general supervision and answers calls from physician and pharmacy providers through pharmacy hotline. Assist in administering prior authorizations according to established guidelines and assists Clinical Pharmacists in case review process. Actively participate in physician education and outreach program and perform claims analysis for drug utilization review (DUR), fraud, abuse, and over-utilization. Job Description Able to work in a constant state of alertness and safe manner Assist department in reaching call center goals based on standards of productivity (percent of calls answered within 30 seconds, percent of abandoned calls). Assist department in reaching call center goals based on standards of quality (providing accurate information to physicians and pharmacies) Maintain knowledge of different pharmacy benefit packages under Medicaid and Medicare to be communicated to providers and other departments Assist Clinical Pharmacists in responding to physician and pharmacy providers’ telephone calls, to provide safe and effective formulary alternatives, resolve processing errors (i.e. eligibility, plans limits exceeded, national drug code (NDC) not covered, refill too soon, etc.). Assist Clinical Pharmacists in reviewing clinical cases including researching previous medication history, obtaining additional information as it pertains to the case, notifying physician’s office of approval and/or denial of prior authorization request, generating letters for approved medication requests, and expedite prior authorization requests. Interact with other departments including Member Relations, Special Needs Unit, Complaints and Grievances, Disease Management, and Utilization Management; assisting in resolving pharmacy issues. Conduct clinical DUR on pharmacy claims and make recommendations for recipient restriction program. Provide ideas and suggestions to help improve quality and flow of pharmacy department. May perform other duties as assigned.

Requirements

• High School Diploma/GED
• 1 year of’ experience in pharmacy.
• Familiar with a managed care and delegated pharmacy services
• Excellent written and oral communication skills
• Self-motivated and a team player.
• Proficient in Excel and relational databases such as MHS, CIC, DST, Macess
• CPhT - Certified Pharmacy Technician - Pharmacy Technician Certification Board

Responsibilities

• Works under general supervision and answers calls from physician and pharmacy providers through pharmacy hotline.
• Assist in administering prior authorizations according to established guidelines and assists Clinical Pharmacists in case review process.
• Actively participate in physician education and outreach program and perform claims analysis for drug utilization review (DUR), fraud, abuse, and over-utilization.
• Able to work in a constant state of alertness and safe manner
• Assist department in reaching call center goals based on standards of productivity (percent of calls answered within 30 seconds, percent of abandoned calls).
• Assist department in reaching call center goals based on standards of quality (providing accurate information to physicians and pharmacies)
• Maintain knowledge of different pharmacy benefit packages under Medicaid and Medicare to be communicated to providers and other departments
• Assist Clinical Pharmacists in responding to physician and pharmacy providers’ telephone calls, to provide safe and effective formulary alternatives, resolve processing errors (i.e. eligibility, plans limits exceeded, national drug code (NDC) not covered, refill too soon, etc.).
• Assist Clinical Pharmacists in reviewing clinical cases including researching previous medication history, obtaining additional information as it pertains to the case, notifying physician’s office of approval and/or denial of prior authorization request, generating letters for approved medication requests, and expedite prior authorization requests.
• Interact with other departments including Member Relations, Special Needs Unit, Complaints and Grievances, Disease Management, and Utilization Management; assisting in resolving pharmacy issues.
• Conduct clinical DUR on pharmacy claims and make recommendations for recipient restriction program.
• Provide ideas and suggestions to help improve quality and flow of pharmacy department.
• May perform other duties as assigned.

Benefits

• Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts.
• Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service.
• All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED