Remote Prior Authorization Pharmacy Tech II

Elevance Health, Inc.; United States; Hybrid; USD 42,000 - 54,000; Full time

Job summary

Elevance Health, Inc. is seeking a Prior Authorization Pharmacy Technician II to interpret and data-enter moderately complex prescriptions and manage prior authorization processing.

This role supports hybrid/virtual work with required in-person training sessions and may consider alternate locations within commuting distance from Mason, OH. Accountabilities include verifying member information, educating on prescription benefits, processing PA requests, resolving grievances, and maintaining

Qualifications

• Active state license if required by state law, professional license in good standing.
• HS diploma or equivalent with minimum 2 years of pharmacy experience or equivalent education/experience.
• URAC competencies include strong oral, written and interpersonal communication, problem solving, facilitation and analytical skills.

Responsibilities

• Verifies member information and inputs data for the pharmacists.
• Educates members on pharmacy rules related to prescriptions and resources or assistance programs.
• Processes prior authorization requests from physician offices and ensures Medicare compliance; informs relevant parties of determinations.
• Responds to grievances and appeals issues.
• Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits.
• Maintains record keeping of prior authorizations, rebates, and monthly reports.

Skills

Communication skills

Problem solving

Interpersonal skills

Analytical skills

Education

High School Diploma

2 years pharmacy experience

Job description

Elevance Health, Inc. is seeking a Prior Authorization Pharmacy Technician II to interpret and data-enter moderately complex prescriptions and manage prior authorization processing.

This role supports hybrid/virtual work with required in-person training sessions and may consider alternate locations within commuting distance from Mason, OH. Accountabilities include verifying member information, educating on prescription benefits, processing PA requests, resolving grievances, and maintaining