Pharmacy Prior Authorization Technician (Hybrid)

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

Job summary

Blue Shield of California is seeking a Pharmacy Technician, Intermediate to join the Pharmacy Prior Authorization team. You will resolve outpatient pharmacy benefit inquiries, including prescription claim issues and communicating formulary guidelines and alternatives.

The role reports to the Supervisor, Pharmacy Services Operations and requires a California Certified Pharmacy Technician license and about 2 years of pharmacy-related experience.

Qualifications

• Requires a California Certified Pharmacy Technician license.
• Requires 2 years of pharmacy related experience and training; or equivalent combination of education and 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

Skills

Pharmacy experience

Phone & verbal communication

Time management

Education

California Certified Pharmacy Technician license

Job description

Blue Shield of California is seeking a Pharmacy Technician, Intermediate to join the Pharmacy Prior Authorization team. You will resolve outpatient pharmacy benefit inquiries, including prescription claim issues and communicating formulary guidelines and alternatives.

The role reports to the Supervisor, Pharmacy Services Operations and requires a California Certified Pharmacy Technician license and about 2 years of pharmacy-related experience.