Pharmacy Tech II - Prior Authorization & Formulary Specialist

Elevance Health; Miami, Northern (FL, KY); Hybrid; USD 36,000 - 48,000; Full time

Job summary

Elevance Health is seeking a Pharmacy Technician to interpret and enter moderately complex prescriptions, process prior authorizations, and troubleshoot adjudication issues. The role supports a hybrid workforce with on-site participation requirements.

Qualified candidates will hold a State or National Pharmacy Technician Certification, a HS diploma with 2+ years of pharmacy experience, and possess strong communication, problem-solving, facilitation, and analytical skills.

Qualifications

• Active, professional license (as required by state law) to practice as a Pharmacy Technician.
• HS diploma or equivalent with a minimum of 2 years of pharmacy experience; or equivalent education/experience.
• Associates level expected skills: oral and written communication, problem-solving, facilitation, and analytical abilities.

Responsibilities

• Verifies member information and inputs data for pharmacists.
• Educates members on pharmacy rules, prescriptions, and medication resources.
• Processes prior authorization requests and ensures Medicare compliance; informs relevant parties of determinations.
• Provides resolution to grievances and appeals.
• Responds to inquiries from physicians, sales team, and members about formulary and prescription benefits.
• Generates reports on rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports.
• Maintains record keeping of prior authorizations, rebates, and monthly reports.

Skills

Communication skills

Problem-solving

Analytical skills

Facilitation skills

Interpersonal skills

Education

Pharmacy Technician Certification (State/National)

Job description

Elevance Health is seeking a Pharmacy Technician to interpret and enter moderately complex prescriptions, process prior authorizations, and troubleshoot adjudication issues. The role supports a hybrid workforce with on-site participation requirements.

Qualified candidates will hold a State or National Pharmacy Technician Certification, a HS diploma with 2+ years of pharmacy experience, and possess strong communication, problem-solving, facilitation, and analytical skills.