Pharmacy Services Technician - Medical Drug PA Team

Regence; Medford (OR); Remote; USD 10,000 - 60,000; Full time

Job summary

An established industry player is seeking a Pharmacy Services Technician to join their dedicated team. This role involves supporting pharmacy operations by addressing non-clinical pharmacy issues, assisting with formulary processes, and communicating with health care professionals. The ideal candidate will possess a strong knowledge of pharmaceuticals and medical terminology, with a focus on delivering exceptional service. Join a purpose-driven organization that values innovation and offers comprehensive benefits, including health coverage, generous paid time off, and a market-leading retirement plan. This is an exciting opportunity to contribute to improving health care and making lives better.

Benefits

Medical, dental and vision coverage

Annual employer contribution to health savings account

Generous paid time off

Company match on 401(k) contributions

Paid parental time off

Award-winning wellness programs

Employee Assistance Fund

Commute and parking benefits

Qualifications

• 2 years of experience as a pharmacy technician in managed care or pharmacy settings.
• Ability to interact effectively with health care professionals.

Responsibilities

• Respond to non-clinical pharmacy issues and assist with operational processes.
• Communicate determinations to providers and members as necessary.

Skills

Medical terminology knowledge

Health care coding systems (ICD 10, CPT, HCPCS)

HIPAA regulations knowledge

Pharmaceutical products knowledge

Office practices and procedures knowledge

Business grammar and techniques

Effective interaction with health care professionals

Pharmaceutical pricing calculations

Typing skills (30 wpm, 60 wpm preferred)

Basic computer programs skills (Word, Excel)

Education

High school diploma or related certificate

Tools

Standard business machines (calculators, copiers, faxes)

Word processing software (Word, Excel)

Job description

Pharmacy Services Technician - Medical Drug PA Team

Join to apply for the Pharmacy Services Technician - Medical Drug PA Team role at Regence BlueCross BlueShield of Oregon.

Work from home within WA, OR, ID or UT.

Who We Are Looking For

Every day, Cambia’s dedicated team of Pharmacy Technicians are living our mission to make health care easier and lives better. The Pharmacy team is a corporate-wide technical support resource for pharmacy benefit, reimbursement, and other drug use issues which do not require clinical judgment. This function assists the Clinical Pharmacy Consultants and Pharmacy Services staff with formulary-related operations and other operational processes which require knowledge and experience with pharmaceuticals.

Qualifications

• High school diploma or related certificate.
• 2 years of experience as a pharmacy services technician in managed care, health insurer, pharmacy benefit manager (PBM), provider setting or other licensed pharmacy setting or equivalent combination of education and experience.

Skills And Attributes

• Knowledge of Medical terminology, health care coding systems such as ICD 10, CPT and HCPCS and HIPAA regulations.
• Knowledge of Pharmaceutical products, including orals, injectables, infusion products, and chemotherapy.
• Knowledge of general office practices and procedures.
• Demonstrated knowledge of Grammar and techniques of business practice.
• Ability to interact effectively with a variety of health care professionals, including physicians, nurses, pharmacists, and billing staff both internally and externally.
• Demonstrate maturity, tact, diplomacy, and persuasiveness.
• Demonstrated ability to perform pharmaceutical pricing calculations.
• Ability to type 30 words per minute, 60 wpm preferred.
• Demonstrated ability to operate a variety of standard business machines including calculators, copiers, and faxes.
• Basic computer programs skills (Word, Excel, etc.).
• Ability to organize, plan, and prioritize daily workflow and projects within time constraints.
• Experience with health insurance and/or prescription benefits preferred.

What You Will Do At Cambia

• Perform all duties as described in this document unless doing so would require clinical judgement. In any situation in which clinical judgment is necessary, the Pharmacy Services Technician will seek assistance from appropriate medical personnel.
• Responds to non-clinical pharmacy issues from providers, pharmacy services staff, case managers, preauthorization nurses, ENCC personnel, and government programs personnel and customer service.
• Completes daily formulary operational processes, including tracking, processing, and obtaining appropriate documentation for pharmacy medical exception requests, prior authorization requests, reconsiderations, and appeals.
• Prepares reconsideration requests for Clinical Pharmacy Consultant review by obtaining and organizing appropriate documentation.
• Communicates (orally and by written documentation) information and determinations to providers and members as necessary.
• Obtains and organizes drug utilization data, including patient specific and population-based data.
• Assists with auditing and investigations of medication-related claims, cases, and providers to identify misuse of medications.
• Investigates and organizes workflow for claims referred to Pharmacy Services for review and allowable determination.
• Supports wellness and disease state management programs for Pharmacy Service and corporately.
• Contributes to and supports the corporation’s quality initiatives through process improvement teams.

The expected hiring range for a Pharmacy Services Technician is $24.00 - $29.00 an hour depending on skills, experience, education, and training; relevant licensure / certifications; and performance history.

About Cambia

Working at Cambia means being part of a purpose-driven, award-winning culture built on trust and innovation anchored in our 100+ year history.

Benefits

• Medical, dental and vision coverage for employees and their eligible family members, including mental health benefits.
• Annual employer contribution to a health savings account.
• Generous paid time off varying by role and tenure in addition to 10 company-paid holidays.
• Market-leading retirement plan including a company match on employee 401(k) contributions.
• Up to 12 weeks of paid parental time off.
• Award-winning wellness programs that reward you for participation.
• Employee Assistance Fund for those in need.
• Commute and parking benefits.

We are an Equal Opportunity employer dedicated to a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law.