Health Plan Pharmacy Technician

MedStar Health; Columbia (MD); On-site; USD 27,000 - 47,000; Full time

Job summary

MedStar Health in Columbia, MD seeks a Health Plan Pharmacy Technician to work with Clinical Pharmacists and Medical Directors to ensure safe, effective medication use for MedStar Family Choice members and providers.

The role focuses on prior authorization management, data maintenance, and collaboration with the quality team to meet HEDIS targets. Maryland licensure is required at hire; 1–2 years of pharmacy technician experience is preferred.

Qualifications

• 1–2 years of pharmacy technician experience.
• Experience in specialty or hospital pharmacy preferred.
• MD pharmacy technician license required upon hire.
• Completion of hospital-based or community college technician program preferred.

Responsibilities

• Facilitates approval/denial of prior authorization requests from members and providers.
• Provides clinicians with necessary information to render decisions.
• Adheres to prior authorization requirements and maintains provider relationships.
• Maintains pharmacy databases and generates reports as requested.
• Assists in formulary updates and regulatory reconciliation with state regulators.
• Other duties as assigned.

Skills

Pharmacy technician experience

Specialty/Hospital pharmacy experience

Education

High School Diploma or GED

Associate's degree

Hospital/Community college technician training program

Job description

About the Job

General Summary of Position

The Health Plan Pharmacy Technician works closely with the Clinical Pharmacists and Medical Directors to facilitate the safe and effective use of medications by MedStar Family Choice members and their providers. The technician makes members and their needs a primary focus of one's actions; develops and sustains productive member relationships, maintains knowledge of and assures departmental compliance with Medstar Family Choice's policies and procedures and applicable regulatory requirements and accreditation standards.

Primary Duties and Responsibilities

• Facilitates the approval or denial of medication prior authorization requests from members and providers in a timely manner. Responsible for making outbound/receiving inbound calls and speaking with providers' offices for additional information or clarifications needed to process the prior authorization request.
• Provides the Clinical Pharmacist or Medical Director reviewing each request with all necessary clinical information to render an appropriate decision.
• Adheres to MedStar Family Choice prior authorization requirements as stipulated by the department.
• Cultivates relationships with providers and their staff to facilitate rapid resolutions to all requests.
• Works closely with the Clinical Pharmacists as well as the quality team to identify HEDIS targets that can be impacted by the pharmacy team.
• Makes appropriate outreach to members and providers regarding the HEDIS measure.
• Tracks progress making regular reports to the Clinical Pharmacist and Chief Medical Officer or designee.
• Maintains and updates internal pharmacy databases. Ensures database information and appended files are current and accessible to staff. Generates reports and other information requested on a scheduled/as needed basis.
• Assists in the preparation of monthly pharmacy formulary updates for State regulator.
• Receives monthly Corrective managed care file from State regulator and performs reconciliation of State regulator and MFC data assist in preparation of monthly Corrective Managed Care reconciliation report to State regulator.
• Other duties as assigned

Minimal Qualifications

Education

• High School Diploma or GED required
• Associate's degree preferred
• Graduation from a hospital-based or community college technician training program preferred

Experience

• 1-2 years experiences as a Pharmacy Technician with 1 year in a Specialty Pharmacy or Hospital pharmacy environment preferred

Licenses and Certifications

• National pharmacy technician license EXCPT or PTCB required upon hire
• Maryland pharmacy technician license required upon hire

This position has a hiring range of

USD $19.55 - USD $34.25 /Hr.