See all roles

Pharmacy Technician - Prior Auth Review (Remote PST Hours)

Work from home Full-time role Hiring

reputed company is hiring for a Pharmacy Technician who is BOTH State Licensed/Certified and Nationally certified. This role is 100% remote, and the shift times we are filling are as follows. Monday through Friday 7a-330pm PST, 8a-430pm PST, 9a-530pm PST, 10a-630p PST, 11a-730pm PST Rotating weekends This role will be reviewing incoming Prior Auth requests for Medicaid and Marketplace members through both the medical and pharmacy benefit. There will be coordination with pharmacists to reputed company determinations on cases. Highly qualified candidates for this role will have the following experience- ? Positive "Can Do" attitude ? Specialty Pharmacy (any) and Retail Pharmacy (at least 3 years) experience are ideal ? Must be computer savvy- able to work reputed company several computer systems at once, MS Note experience a plus ? Managed care experience ? High level of communication skills, both written and verbal ? Able to utilize resources to work independently 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's 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. Key Words: Pharmacy Technician, Pharm Tech, Tech, National Certification, State License, Certification, Claims, Pharmacy Claims, Pharmacy, PBM, Customer Service, National Certified Pharmacy Technician (CPhT) certification, Medicaid, Medicare, Managed Care, MCO, Exchange, PBM, Pharmacy Benefit Management, Prior Auth Same Posting Description for Internal and External Candidates About Us reputed company is a reputed company fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can reputed company a difference in the lives of others. reputed company offers a competitive benefits and compensation package. reputed company is an Equal Opportunity Employer (EOE) M/F/D/V. Apply Job!

You might like

reputed company of Claim Processor - Remote Work from Home!

Work from home Full-time role

SALES - Starlink Installation Pros - Work From Home

Work from home Full-time role

Senior Software Engineer - Supply Chain - Sourcing (Remote)

Work from home Full-time role

Senior Sales Executive (North America) - reputed company (Hybrid)

Work from home Full-time role

Chat & Phone Tech Support/Customer Service Agent - Seasonal

Work from home Full-time role

Chat & Phone Tech Support/Customer Service Agent - Seasonal

Work from home Full-time role

Remote Sales Representative ? No Cold Calling-We Train! $50,000-$250,000

Work from home Full-time role

Windows / Linux Systems Administrator ? Work From Home

Work from home Full-time role

reputed company Remote (Data Entry| Advance Level Job) Express Interest

Work from home Full-time role

Customer Support - Chats and Tickets - LATAM (4033)

Work from home Full-time role

[Remote] Customer Service Associate (Work From Home)

Work from home Full-time role

reputed company Virtual Remote Job (Entry Level, WFH) $70000/Year

Work from home Full-time role

Teleservices Consultant

Work from home Full-time role

Mid-Level Tax Preparer and accountant Remote

Work from home Full-time role

[PART_TIME Remote] Walmart Data Entry Work From Home

Work from home Full-time role

Technical Internship

Work from home Full-time role

Licensed Health Insurance Agent- REMOTE for Open Enrollment

Work from home Full-time role

Associate Staff Engineer

Work from home Full-time role

reputed company

Work from home Full-time role

Senior reputed company Backend Developer

Work from home Full-time role