Pharmacy Technician, Prior Auth (Remote)

Molina Healthcare; Northern (KY); Hybrid; USD 17,000 - 36,000; Full time

Benefits offered by this job

Remote work

Competitive benefits

Job summary

Molina Healthcare is hiring for a remote Pharmacy Technician. This role is 100% remote with hours Monday–Friday, 10:00 a.m. to 6:30 p.m. Central Time.

The position supports pharmacy technician activities and contributes to pharmacy strategy to optimize medication-related health outcomes and cost-effective member care.

Requires a CPhT and 2+ years of experience; responsibilities include reviewing requests, approvals/denials, prior authorizations, and collaboration with providers and members.

Qualifications

• At least 2 years pharmacy technician experience or equivalent.
• CPhT certification and/or state license active and unrestricted.
• Ability to abide by Molina policies.
• Ability to maintain attendance to support required quality and quantity of work.
• Ability to maintain confidentiality and comply with HIPAA.
• Ability to establish and maintain positive work relationships with coworkers, clients, members, providers and customers.
• Excellent verbal and written communication skills.
• Proficiency in Microsoft Office suite including Excel.

Responsibilities

• Review non-formulary or prior authorization requests against plan criteria.
• Enter approvals or denials of requests.
• Facilitate prior authorization requests within policies and procedures.
• Participate in development/administration of pharmacy programs to optimize drug utilization and cost savings.
• Identify and report operational issues to leadership.
• Assist member services, pharmacies, and providers with resolution of claims and access issues.
• Articulate management policies to providers and staff.

Skills

Verbal communication

Written communication

Microsoft Office

Excel

HIPAA compliance

Education

Certified Pharmacy Technician (CPhT)

Tools

Microsoft Office

Excel

Job description

Molina Healthcare is hiring for a remote Pharmacy Technician- This role is 100% remote.
The hours will be Monday through Friday be 10am to 630pm, Central Standard Time.

This role will provide support for pharmacy technician activities. Contributes to overarching pharmacy strategy for optimization of medication related health care outcomes, and quality cost-effective member care.

Essential Job Duties

• Performs initial receipt and review of non-formulary or prior authorization requests against pharmacy plan approved criteria; requests additional information from providers as needed to properly evaluate requests.
• Accurately enters approvals or denials of requests.
• Facilitates prior authorization requests within established pharmacy policies and procedures.
• Participates in the development/administration of pharmacy programs designed to enhance the utilization of targeted drugs and identification of cost-saving pharmacy practices.
• Identifies and reports pharmacy departmental operational issues and resource needs to appropriate leadership.
• Assists Molina member services, pharmacies, and health plan providers in resolving member prescription claims, prior authorizations, and pharmacy service access issues.
• Articulates pharmacy management policies and procedures to pharmacy/health plan providers, Molina staff and others as needed.

Required Qualifications

• At least 2 years pharmacy technician experience, or equivalent combination of relevant education and experience.
• Certified Pharmacy Technician (CPhT) and/or state pharmacy technician license (state specific if state required). If licensed, license must be active and unrestricted in state of practice.
• Ability to abide by Molina policies.
• Ability to maintain attendance to support required quality and quantity of work.
• Ability to maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA).
• Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers.
• Excellent verbal and written communication skills.
• Microsoft Office suite (including Excel), and applicable software program(s) proficiency.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $12.19 - $26.42 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.