Remote Pharmacy Technician: Utilization & Care Coordination

Evolving Solution Services; Roseburg, Northern (OR, KY); Hybrid; USD 33,000 - 39,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

401(k) with company match and vesting

Vacation/PTO, sick leave, federal hols

Life insurance

Fitness reimbursement

Tuition reimbursement

Job summary

The Pharmacy Technician at Umpqua Health will support medical management functions, including utilization management, pharmacy management, and care coordination, ensuring compliance with policies and state/federal regulations.

Working under general supervision, you’ll liaise with Oregon Health Plan members, providers, pharmacies, and community partners to support coordinated care and timely processing of pharmacy services.

Qualifications

• There is current National and Oregon CPhT licensure.
• Minimum of one year of experience as a pharmacy technician.
• Fluent in pharmaceutical and medical terminology.
• Proficient with Microsoft Office Suite (Word, Excel, Outlook) and data entry.
• Must have valid driver's license and proof of automobile insurance.
• Must not be suspended, excluded, or debarred from federal health care programs (Medicare/Medicaid).

Responsibilities

• Maintains knowledge of Oregon Medicaid rules governing coverage determinations.
• Performs initial reviews of pharmacy and medical service coverage requests and documents timely determinations.
• Communicates with providers regarding formulary options, prior authorizations, and coverage criteria.
• Performs accurate data entry into claims adjudication systems.
• Supports Medication Management program activities and outreach to members, pharmacies, and providers for coordination of care.

Job description

The Pharmacy Technician at Umpqua Health will support medical management functions, including utilization management, pharmacy management, and care coordination, ensuring compliance with policies and state/federal regulations.

Working under general supervision, you’ll liaise with Oregon Health Plan members, providers, pharmacies, and community partners to support coordinated care and timely processing of pharmacy services.