Pharmacy Technician, Intermediate

Blue Shield of California; Rancho Cordova (CA); Hybrid; USD 30,000 - 41,000; Full time

Job summary

Blue Shield of California is seeking an Intermediate Pharmacy Technician to support the outpatient prior authorization program. You will resolve coverage inquiries, assist with formulary guidance, and communicate with physicians and pharmacies to ensure accurate resolution of claims and benefit inquiries.

The role requires a California Certified Pharmacy Technician license, 2 years of related experience, and the ability to manage multiple tasks with strong communication and scheduling

Qualifications

• Requires a California Certified Pharmacy Technician license.
• Requires 2 years of pharmacy related experience and training; or equivalent combination of education and experience.
• Basic understanding of internal procedures and policies to ensure effective execution of tasks.
• Ability to multi-task, set priorities, and manage time effectively.
• Requires the ability to work a flexible schedule and weekends as required.
• Strong phone and verbal communication skills along with active listening skills.

Responsibilities

• Coordinate, assist in, and support implementation of procedures and guidelines for the drug prior authorization program for the outpatient Pharmacy Benefit.
• Evaluate prior authorization requests based on medication policy and operational principles.
• Provide drug usage history and other pertinent pharmacy benefit related inquiries to internal business partners to assist in case specific reviews and drug evaluations.
• Communicate with the physician, physician's office staff, pharmacies, and internal business partners to assist with accurate and efficient resolution of pharmacy benefit inquiries.
• Clearly communicate formulary alternatives and prior authorization criteria, and discusses pharmacy benefit coverage when required.

Skills

Verbal communication

Active listening

Multi-tasking

Job description

Job Description

Your Role

The Pharmacy Prior Authorization team provides efficient and accurate responses to external customers (physicians, office staff, pharmacy providers, members, and brokers) and internal team members for all outpatient pharmacy benefit inquires. The Pharmacy Technician, Intermediate will report to the Supervisor, Pharmacy Services Operations. In this role you will resolve outpatient pharmacy benefit coverage inquiries, including prescription claim processing problems, and communication of drug formulary guidelines and alternatives.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Responsibilities

Your Work

In this role, you will:

• Coordinate, assist in, and support implementation of procedures and guidelines for the drug prior authorization program for the outpatient Pharmacy Benefit
• Evaluate prior authorization requests based on medication policy and operational principles
• Provide drug usage history and other pertinent pharmacy benefit related inquiries to internal business partners to assist in case specific reviews and drug evaluations
• Communicate with the physician, physician's office staff, pharmacies, and internal business partners to assist with accurate and efficient resolution of pharmacy benefit inquiries
• Clearly communicate formulary alternatives and prior authorization criteria, and discusses pharmacy benefit coverage when required

Qualifications

Your Knowledge and Experience

• Requires a California Certified Pharmacy Technician license
• Requires 2 years of pharmacy related experience and training; or equivalent combination of education and experience
• Basic understanding of internal procedures and policies needed to ensure effective execution of assigned tasks
• Ability to multi-task, set priorities, and manage time effectively
• Requires the ability to work a flexible schedule and weekends as required
• Strong phone and verbal communication skills along with active listening skills

Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.

About the Team

About Blue Shield of California

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies.

At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals.

Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities - join us!

Our Values:

• Honest. We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
• Human. We strive to listen and communicate effectively, showing empathy by understanding others' perspectives.
• Courageous. We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

Our Workplace Model

We believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility - providing clear expectations while respecting the diverse needs of our workforce. Our workplace model is designed around intentional in-person interaction, collaboration, connection, creativity and flexibility:

• For most teams, this means coming into the office two days per week.
• Employees living more than 50 miles from an office location, out of state employees, and employees in certain member-facing roles should work with their manager to determine in-office time based on business need.
• For employees with medical conditions that may impact their ability to work in-office, we are committed to engaging in an interactive process and providing reasonable accommodations to ensure their work environment is conducive to their success and well-being.

The Company reserves the right to require more presence in the office based on business needs, and requirements are subject to change with periodic reviews.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Please click here for further physical requirement detail.

Equal Employment Opportunity:

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.