Pharmacy Care & Prior Authorization Specialist

Thomas Jefferson University Hospitals, Inc.; Philadelphia (Philadelphia County); On-site; USD 38,000 - 52,000; Full time

Benefits offered by this job

Medical insurance

Tuition assistance

Retirement plan

Job summary

Thomas Jefferson University Hospitals, Inc. seeks a Pharmacy Technician to support calls from physicians and pharmacy providers via a dedicated hotline. You will assist with prior authorizations and aid Clinical Pharmacists in case review and DUR processes.

You will participate in physician education, outreach, and claims analysis for drug utilization review, fraud, abuse, and over-utilization, collaborating with multiple departments.

Qualifications

• High School Diploma or GED required.
• 1 year of experience in pharmacy preferred.
• Familiar with managed care and delegated pharmacy services.
• Excellent written and oral communication skills.
• Self-motivated and a team player.
• Proficient in Excel and databases (MHS, CIC, DST, Macess).
• CPhT certification required.

Responsibilities

• Answer calls from physicians and pharmacy providers via hotline.
• Assist with prior authorizations per established guidelines.
• Support Clinical Pharmacists in case reviews and DUR processes.
• Participate in physician education and outreach activities.
• Analyze claims for drug utilization review, fraud, abuse, and over-utilization.
• Communicate formulary alternatives and resolve processing errors.

Skills

Communication skills

Team player

Self-motivated

Excel

Relational databases

Education

High School Diploma/GED

CPhT - Certified Pharmacy Technician

Tools

MHS

CIC

DST

Macess

Job description

Thomas Jefferson University Hospitals, Inc. seeks a Pharmacy Technician to support calls from physicians and pharmacy providers via a dedicated hotline. You will assist with prior authorizations and aid Clinical Pharmacists in case review and DUR processes.

You will participate in physician education, outreach, and claims analysis for drug utilization review, fraud, abuse, and over-utilization, collaborating with multiple departments.