Hybrid Pharmacy Technician - Adherence and Operations

Alignment Healthcare USA, LLC in; Orange (CA); Hybrid; USD 41,000 - 62,000; Full time

Job summary

Alignment Health is seeking a Hybrid Pharmacy Technician to support the Pharmacy Department in California. The role involves administrative tasks and coordinating with PBM programs while ensuring CMS requirements are met.

Candidates should have at least 1 year of customer experience, a Pharmacy Tech license, HS diploma, and preferably a Pharmacy Tech certification. Bilingual skills are a plus. This position offers growth in a fast-paced healthcare team.

Qualifications

• Minimum 1 year customer experience.
• Prior Pharmacy Tech experience in a healthcare setting preferred.
• High School Diploma or GED required.
• Associates Degree in Pharmacy Tech preferred.
• Pharmacy Tech license required.
• Certified Pharmacy Technician preferred.
• Bilingual English/Spanish or English/Chinese preferred.

Responsibilities

• Assists with the daily operations of the various Pharmacy Department programs, multiple projects and participate in Plan and regulatory agency audits, as necessary.
• Makes high volume of outbound calls to members, prescribers, and pharmacies in regard to the Adherence program.
• Assists members in refilling their medications and reaching out to the prescriber's office if a member requires additional refills on their maintenance medications.
• Drafts routine reports and correspondence.
• Supports all CMS required oversight processes of PBM including but not limited to: Rebates, Explanation of Benefit reports, Transition Reports, and Part B vs Part D.
• Responds to inquiries from physicians, members, and pharmacies related to formulary and prescription benefits.
• Retrieves accurate, concise, applicable, and timely drug information.
• Interacts with Plan's contracted PBM to ensure communications and information to other internal Plan departments as applicable.
• Interacts with Plan's contracted PBM in regard to Prior Authorizations, Overrides and in resolving issues pertaining to member's medications.
• Makes outbound calls to pharmacies and prescribers to resolve prescription issues such as medication requires Prior Authorization, assist retail/mail order pharmacies in resolving third party rejections, and reviewing daily rejections while ensuring we are CMS compliant.
• Interacts with internal plan departments to address pharmacy related issues.
• Works closely with compliance department to make sure Pharmacy Programs meet the criteria established by CMS.
• Ensures all HMO's members information is kept confidential according to HIPAA.
• Other duties as assigned.

Skills

Customer service

Communication

Bilingual EN/ES

Teamwork

Education

High School Diploma or GED

Associate degree in Pharmacy Tech

Job description

Alignment Health is seeking a Hybrid Pharmacy Technician to support the Pharmacy Department in California. The role involves administrative tasks and coordinating with PBM programs while ensuring CMS requirements are met.

Candidates should have at least 1 year of customer experience, a Pharmacy Tech license, HS diploma, and preferably a Pharmacy Tech certification. Bilingual skills are a plus. This position offers growth in a fast-paced healthcare team.