Remote Managed Care Pharmacy Technician (PBM & PA)

Excellus BCBS; City of Binghamton (NY); Presencial; USD 29.000 - 46.000; Jornada completa

Descripción de la vacante

Excellus BCBS is seeking a Managed Care Pharmacy Technician to assist with member and client programs, focusing on optimizing pharmacy benefits and prescription processes. Under pharmacist supervision, you will handle calls from members, physicians, and pharmacists, provide information on formulary coverage, and support prior authorization work.

You will implement and monitor pharmacy benefit tools, assist in data reporting, and participate in on-call rotations to address after-hour pharmacy

Formación

• High school diploma with a minimum of two years’ experience in health-related field; associates degree preferred.
• Pharmacy Technician certification (CPhT), LPN, Medical Assistant/Technologist background strongly preferred.
• Basic understanding of medical terminology and diagnosis codes.
• Understanding of prescription and medical benefits as it applies to utilization review processes.
• Proficient use of Microsoft Office suite.

Responsabilidades

• Review medical exception requests based on pharmacist-created algorithms.
• Assess prior authorization requests against criteria for approval.
• Data entry and monitoring of member profiles for prior authorization and ad hoc reports.
• Provide information to physicians and pharmacists about initiatives involving prescriptions and benefits.
• Assist with prior authorization, exception, and clinical necessity reviews.

Conocimientos

Strong verbal communication

Strong written communication

Professionalism

Customer service orientation

Analytical abilities

Problem solving

Educación

High school diploma

Associate degree preferred

CPhT certification

LPN or Medical Assistant background

Herramientas

Microsoft Office

Facets system

Descripción del empleo

Excellus BCBS is seeking a Managed Care Pharmacy Technician to assist with member and client programs, focusing on optimizing pharmacy benefits and prescription processes. Under pharmacist supervision, you will handle calls from members, physicians, and pharmacists, provide information on formulary coverage, and support prior authorization work.

You will implement and monitor pharmacy benefit tools, assist in data reporting, and participate in on-call rotations to address after-hour pharmacy