Pharmacy Technician II (REMS Program)

Elevance Health; Florida; Hybrid; USD 38,000 - 48,000; Full time

Job summary

Elevance Health BioPlus Specialty Pharmacy in Lake Mary, FL is seeking a Pharmacy Technician II to join our hybrid team. This role supports doctors and members by interpreting and data entering moderately complex prescriptions, processing prior authorizations, and resolving adjudication issues.

Primary duties include verifying member information, educating on prescription rules, handling PA requests, and maintaining records.

Qualifications

• Requires HS diploma or equivalent and minimum of 2 years of pharmacy experience.
• Requires an active, professional license, if required by state law, State Pharmacy Technician Certification or National Certification.

Responsibilities

• Verifies member information and inputs data for the pharmacists.
• Educates members on pharmacy rules related to prescriptions and medication resources or assistance programs.
• 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.
• Generates reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports.
• Maintains record keeping of prior authorizations, rebates, and monthly reports.
• Contacts healthcare providers to clarify prescription details, secure missing information, and resolve discrepancies.
• Help deliver high-quality lifesaving pharmacy care for patients with complex or medical conditions.
• Responsible for processing specialty prescriptions orders with accuracy, efficiency, professionalism.

Skills

Pharmacy experience

Specialty pharmacy

Education

State/National Pharmacy Technician Certification

HS diploma or equivalent

Job description

Pharmacy Technician II

Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. This position will be based at the following location: 3200 Lake Emma Rd, Ste 1000, Lake Mary, FL.

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 an accommodation is granted as required by law.

Be Part of an Extraordinary Team

BioPlus Specialty Pharmacy is a proud member of the Elevance Health family of companies. BioPlus offer consumers and providers an unparalleled level of service that’s easy and focused on whole health. Through our distinct clinical expertise, digital capabilities, and broad access to specialty medications across a wide range of conditions, we deliver an elevated experience, affordability, and personalized support throughout the consumer’s treatment journey.

The Pharmacy Technician II is responsible for the interpretation and data entry of moderately complex prescriptions, prior authorization processing, and troubleshooting adjudication issues.

How You Will Make an Impact

Primary duties may include, but are not limited to:

• Verifies member information and inputs data for the pharmacists.

• Educates members on pharmacy based rules related to prescriptions and medication resources or assistance programs.

• 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.

• Generates reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports.

• Maintains record keeping of prior authorizations, rebates, and monthly reports.

• Contacts healthcare providers offices to clarify prescription details, secure missing information, and resolve discrepancies that prevent order processing and/or obtain New prescription for the REMS patients.

• Help deliver high-quality lifesaving pharmacy care for patients with complex or medical conditions.

• Responsible for processing specialty prescriptions orders with accuracy, efficiency, professionalism, while ensuring compliance with regulatory requirements, and following internal standard operating procedures.

Minimum Requirements

• 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.
• 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.

Preferred Skills, Capabilities and Experiences

• Three or more years of pharmacy experience is strongly preferred.
• Previous experience working in specialty pharmacies is highly preferred.

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.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the Accessibility Accommodation Request Form and a member of the team will be in contact.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.