Pharmacy Technician – Clinical DUR & Prior Authorization
Jefferson Health
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Benefits offered by this job
Job summary
Jefferson Health is seeking a Pharmacy Technician to answer calls from physicians and pharmacy providers through the pharmacy hotline, assist with prior authorizations, and support Clinical Pharmacists in case reviews. The role includes claims analysis for DUR, fraud, abuse, and over-utilization, with collaboration across departments to resolve issues.
The candidate should have 1 year of pharmacy experience, be familiar with managed care, and possess strong communication skills.
Qualifications
- 1 year of experience in pharmacy
- Familiar with managed care and delegated pharmacy services
- Excellent written and oral communication skills
- Self-motivated and a team player
- Proficient in Excel and relational databases such as MHS, CIC, DST, Macess
- CPhT - Certified Pharmacy Technician
Responsibilities
- Answer calls from physician and pharmacy providers through pharmacy hotline
- Assist in administering prior authorizations according to guidelines
- Assist Clinical Pharmacists in case review process
- Participate in physician education and outreach program
- Perform claims analysis for drug utilization review (DUR), fraud, abuse, and over-utilization
- Interact with multiple departments to resolve pharmacy issues
- Conduct clinical DUR on pharmacy claims and make recommendations
Skills
Education
Tools
Job description
Jefferson Health is seeking a Pharmacy Technician to answer calls from physicians and pharmacy providers through the pharmacy hotline, assist with prior authorizations, and support Clinical Pharmacists in case reviews. The role includes claims analysis for DUR, fraud, abuse, and over-utilization, with collaboration across departments to resolve issues.
The candidate should have 1 year of pharmacy experience, be familiar with managed care, and possess strong communication skills.
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