Hybrid Pharmacy Technician, Prior Authorization Specialist

Blue Shield of California; California (MO); Hybrid; USD 30,000 - 41,000; Full time

Job summary

Blue Shield of California is hiring a Pharmacy Technician, Intermediate to join the Prior Authorization team. You will respond to physicians, pharmacy providers, members, brokers, and internal staff with outpatient pharmacy benefit inquiries and resolve coverage issues, formulary guidance, and alternatives.

The role includes supporting implementation of procedures, evaluating requests, and communicating effectively with physicians and staff.

Qualifications

• Requires a High School Diploma or GED along with completion of a California State Board approved Pharmacy Technician training, certification, or degree program.
• Requires 3 years of pharmacy related experience.
• Basic understanding of internal procedures and policies needed to ensure effective execution of assigned tasks.
• Ability to multi-task, set priorities, and manage time effectively.
• Requires the ability to work a flexible schedule and weekends as required.
• Strong phone and verbal communication skills along with active listening skills.

Responsibilities

• Coordinate, assist in, and support implementation of procedures and guidelines for the drug prior authorization program for the outpatient Pharmacy Benefit
• Evaluate prior authorization requests based on medication policy and operational principles
• Provide drug usage history and other pertinent pharmacy benefit related inquiries to internal business partners to assist in case specific reviews and drug evaluations
• Communicate with the physician, physician’s office staff, pharmacies, and internal business partners to assist with accurate and efficient resolution of pharmacy benefit inquiries
• Clearly communicate formulary alternatives and prior authorization criteria, and discusses pharmacy benefit coverage when required
• Note: This is short term employment

Skills

Pharmacy experience

Communication skills

Time management

Flexibility & weekend availability

Education

High School Diploma or GED

California State Board approved Pharmacy Technician training/certification/degree

Job description

Blue Shield of California is hiring a Pharmacy Technician, Intermediate to join the Prior Authorization team. You will respond to physicians, pharmacy providers, members, brokers, and internal staff with outpatient pharmacy benefit inquiries and resolve coverage issues, formulary guidance, and alternatives.

The role includes supporting implementation of procedures, evaluating requests, and communicating effectively with physicians and staff.