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Magellan Health Services, Inc.

Senior Clinical Pharmacy Technician

Magellan Health Services, Inc. - Maryland Heights, MO

Job Description:

Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.

ESSENTIAL FUNCTIONS:

- 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.

- Monitors telephone system to ensure adequate staffing to maintain client services levels.

- Assesses training needs within the team. Serves as a training resource, mentor and coach to others. Identifies and shares best practices.

- Demonstrates, advocates and reinforces a positive team environment.

- Other duties as assigned.

General Job Information

Title

Senior Clinical Pharmacy Technician

Grade

18

Job Family

Pharmacy Group

Country

United States of America

FLSA Status

United States of America (Non-Exempt)

Recruiting Start Date

7/6/2018

Date Requisition Created

7/6/2018

Minimum Qualifications

Education

GED||&& High School

License and Certifications - Required

CPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy

License and Certifications - Preferred

Other Job Requirements

Responsibilities

PTCB Certification or the ability to obtain PTCB Certification within one year of hire.  Employees in states which require a Pharmacy Technician certification exam may substitute state certification for the 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. Ability to identify and trouble-shoot problematic issues.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled

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General Job Information

Title

Senior Clinical Pharmacy Technician Grade 18

Job Family

Pharmacy Group

Country

United States of America

FLSA Status

United States of America (Non-Exempt)

Recruiting Start Date

7/6/2018

Date Requisition Created

7/6/2018

Minimum Qualifications

Education

GED||&& High School

License and Certifications - Required

CPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy

License and Certifications - Preferred

Other Job Requirements

Responsibilities PTCB Certification or the ability to obtain PTCB Certification within one year of hire. Employees in states which require a Pharmacy Technician certification exam may substitute state certification for the 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. Ability to identify and trouble-shoot problematic issues. Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled >

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20 days 1 hour ago

Magellan Health Services, Inc.

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Please review all application instructions before applying.

Location: Maryland Heights, MO

Company Profile:
As a health care management company, we focus on today's most complex and costly health care services. The depth and breadth of our experience in managing behavioral health care, diagnostic imaging, specialty pharmaceutical services and in providing pharmacy benefits administration enable us to deliver inspired insights and innovative solutions that positively impact both the quality and the cost of some of the nation's fastest growing areas of health care.