Overnight Clinical Pharmacy Technician
Company: Magellan Health
Location: Rancho Cordova
Posted on: January 6, 2021
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Job Description:
Job DescriptionEvaluates and authorizes approval of prior
authorization pharmacy requests from prescribers received by
telephone and/or facsimile using client clinical criteria. *
Determines appropriateness for medications. Communicates decision
to physicians, physician`s office staff, medical management staff
and/or pharmacists. * Researches, resolves and documents prior
authorization outcomes in pharmacy system. * Communicates selected
prior authorization criteria, pharmacy benefit coverage and
formulary alternatives to physicians, physician`s office staff,
medical management staff and/or pharmacists. * Escalates requests
to Pharmacist when request requires extensive clinical review or
denial. * Researches, resolves and documents physician or client
inquiries and grievances and provides verbal or written results to
client, prescriber, provider and/or management. * Performs other
duties as required. Other Job Requirements Responsibilities * CPT:
Certification/licensure in accordance with state requirements. In
the states of Florida, Rhode Island and Michigan, license
registration with the Board of Pharmacy is required without
exception. * National Certification such as PTCB or ExCPT:
Certification or the ability to obtain certification within one
year of hire. Employees in states which require a Pharmacy
Technician certification/registration exam may substitute state
certification/registration for the national certification. * Active
Pharmacist license supersedes requirement for CPT and/or PTCB. *
Specialty or retail pharmacy industry experience, previous
reimbursement experience, and/or working in a health plan/health
care setting. * In-depth knowledge of specialty injectable
prescription drugs, disease states, health plan formulary
management techniques, medical terminology and current diagnostic
and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.). *
Proficiency in Pharmacy computerized systems and software
applications, as well as MS Office Product Suite. * Excellent
written and verbal communication skills. * Ability to follow
clinical criteria and instructions to approve prior authorization
requests. * Minimum of 6 months dispensing or retail experience
required, or equivalent internal training will be substituted. *
Ability to identify and trouble-shoot problematic issues. General
Job Information Work Experience Pharmacy Education GED (Required),
High School (Required) License and Certifications - Required
CPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements -
Pharmacy License and Certifications - Preferred Magellan Health
Services is proud to be an Equal Opportunity Employer and a
Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must
understand, comply and attest to the security responsibilities and
security controls unique to their position.
Keywords: Magellan Health, Rancho Cordova , Overnight Clinical Pharmacy Technician, Healthcare , Rancho Cordova, California
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