Pharmacy Technician II – Clinical Pharmacy Care Center

Elevance Health; Indianapolis (IN); À distance; USD 25 000 - 39 000; Plein temps

Résumé du poste

Elevance Health, through CarelonRx, is hiring a Pharmacy Technician II – Clinical Pharmacy Care Center (CPCC) for remote full-time work. The role handles interpretation and data entry of moderately complex prescriptions, prior authorization, and adjudication troubleshooting for Medicare, Medicaid, and Commercial members.

You will verify information, process prior authorizations, resolve grievances, respond to inquiries, and educate members on prescriptions, adherence programs, and available

Qualifications

• Active state license or national certification as required by state law.
• High school diploma or equivalent with at least 2 years of pharmacy experience.

Responsabilités

• Verifies member information and inputs data for the pharmacists.
• Processes prior authorization requests and ensures compliance with Medicare requirements.
• Provides resolution to grievances and appeals issues.
• Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits.
• Educates members about prescriptions and medication resources or assistance programs, and about medication adherence topics to align with STARs and HEDIS measures.
• Assists members with scheduling preventive tests or screenings and accessing medication resources.
• Makes outreach to members or providers to close care gaps and improve outcomes.

Connaissances

Call center experience

Formation

State Pharmacy Technician Certification

Description du poste

Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.

Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

Schedule: Monday-Friday, 12:00pm – 8:30pm EST.

CarelonRx is a proud member of the Elevance Health family of companies. CarelonRx pairs a strong, clinical-first lens with deep pharmacy expertise to create solutions that improve outcomes, control costs, and enhance each member’s health.

The Pharmacy Technician II – Clinical Pharmacy Care Center (CPCC) is responsible for the interpretation and data entry of moderately complex prescriptions, prior authorization processing, and troubleshooting adjudication issues. Will service Medicare, Medicaid, and the Commercial member populations.

How You Will Make An Impact

• Verifies member information and inputs data for the pharmacists.
• Processes prior authorization requests from physicians' offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations.
• Provides resolution to grievances and appeals issues.
• Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits.
• Educates members about prescriptions and medication resources or assistance programs, and on on medication adherence-related topics to align closely with STARs Ratings and HEDIS quality measures.
• Assists members with scheduling their preventive test/screenings and medication resources or assistance programs.
• Makes outreach to members or providers to close care gaps and improve outcomes.

Minimum Requirements

• Requires an active, professional license, if required by state law, State Pharmacy Technician Certification or National Certification based on applicable state(s) requirements, to practice as a Pharmacy Technician within the scope of practice in a state or territory of the United States.
• Requires H.S. diploma or equivalent and minimum of 2 years of pharmacy experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities And Experiences

• Call center experience.

For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.