Temporary Pharmacy Technician

Western Health Advantage; Sacramento (CA); Hybrid; USD 32.000 - 36.000; Vollzeit

Zusammenfassung

Western Health Advantage in Sacramento, CA is seeking an experienced Temporary Pharmacy Technician to support utilization management activities at the health plan level. The role involves reviewing authorization requests, coordinating notifications, interpreting benefits, and supporting appeals within regulatory timeframes.

The ideal candidate has a CA Pharmacy Technician license, 3+ years of experience, and strong attention to detail.

Qualifikationen

• High school diploma or equivalent.
• At least three years of experience as a Pharmacy Technician.
• Two years of experience in a utilization management or managed care environment.
• A valid California Pharmacy Technician License in good standing.
• Customer service or call center experience is highly desired.
• Experience preparing professional business correspondence.
• Intermediate computer skills, including email, database systems, word processing, and spreadsheets.
• Strong attention to detail, organization, research, and problem-solving skills.
• Ability to communicate clearly and professionally with members, providers, Medical Groups, and internal departments.
• Ability to speak, read, write, and understand the primary language used in the workplace.

Aufgaben

• Review prescription medication authorization requests using established protocols and criteria.
• Refer questions outside criteria to a Clinical Pharmacist for review.
• Coordinate with the Pharmacy Coordinator and internal departments to finalize authorization decisions and notifications within regulatory timeframes.
• Prepare and send approval, authorization, and denial letters to members and providers.
• Research and prepare pharmacy cases for review by leadership and clinical staff.
• Assist with interpreting pharmacy benefits and prior authorization criteria for staff.
• Support research and resolution of pharmacy-related appeals and grievances.
• Maintain the Formulary Drug List and Prior Authorization criteria per committee decisions.
• Assist with audit activities including DMHC and NCQA reviews.
• Maintain current knowledge of medications and authorization requirements.
• Support provider and member notifications and other administrative tasks.
• Develop and maintain pharmacy policies and training materials.
• Mentor and train junior staff as needed.
• Provide coverage during holidays and peak times to ensure timely case completion.
• Perform additional duties and special projects as assigned.

Kenntnisse

Customer service

Communication skills

Attention to detail

Problem solving

Computer skills

Ausbildung

High school diploma or equivalent

California Pharmacy Technician License

Jobbeschreibung

Temporary Pharmacy Technician

Western Health Advantage
Location: Sacramento, CA (Hybrid)
Salary: $23.00–$26.00 per hour
Department: Pharmacy
Position Type: Temporary
"Our purpose is strong, our impact is lasting, join us on the journey"
Western Health Advantage

Summary Description

Western Health Advantage (WHA) is seeking an experienced Temporary Pharmacy Technician to support pharmacy utilization management activities at the health plan level. Working closely with the Chief Pharmacy Officer, Pharmacy Manager, Medical Directors, Clinical Pharmacists, and Pharmacy Coordinator, this position helps ensure prescription medication requests are reviewed accurately, efficiently, and in accordance with regulatory requirements.

The Pharmacy Technician will review authorization requests using established protocols, coordinate member and provider notifications, assist with pharmacy benefit interpretation, and support pharmacy-related appeals and grievances. The ideal candidate is detail-oriented, knowledgeable about medications and drug classifications, and experienced in a managed care or utilization management environment.

What You’ll Do

• Review prescription medication authorization requests using established protocols and criteria.
• Refer clinical questions or requests falling outside standardized criteria to a Clinical Pharmacist for review.
• Coordinate with the Pharmacy Coordinator and internal departments to ensure authorization decisions and notifications are completed accurately and within regulatory timeframes.
• Prepare and send approval, authorization, and denial letters to members and providers.
• Research and prepare pharmacy cases for review by Pharmacy leadership, Clinical Pharmacists, or the Chief Medical Officer.
• Assist Member Services Representatives and Medical Group staff with interpreting pharmacy benefits and prior authorization criteria.
• Support the research and resolution of pharmacy-related appeals and grievances.
• Help maintain the WHA Formulary Drug List and Pharmacy Prior Authorization criteria based on Pharmacy and Therapeutics Committee decisions.
• Assist with pharmacy and Pharmacy Benefit Manager audit activities, including DMHC and NCQA accreditation reviews.
• Maintain current knowledge of medications, drug classifications, pharmacy benefits, and authorization requirements.
• Support administrative functions, including provider and member notifications and returned-mail processing.
• Assist with developing and maintaining pharmacy policies, training materials, and desktop procedures.
• Provide mentoring and training to less-experienced Pharmacy Technicians and Pharmacy Coordinators, as needed.
• Help provide coverage during holidays and Friday evenings to ensure cases are completed within required regulatory timeframes.
• Perform additional duties and special projects as assigned.

What You’ll Bring

• High school diploma or equivalent.
• At least three years of experience as a Pharmacy Technician.
• At least two years of experience in a utilization management or managed care environment.
• A valid California Pharmacy Technician License in good standing, maintained throughout employment.
• Customer service or call center experience is highly desired.
• Experience preparing professional business correspondence.
• Intermediate computer skills, including email, database systems, word processing, and spreadsheets.
• Strong attention to detail, organization, research, and problem-solving skills.
• Ability to communicate clearly and professionally with members, providers, Medical Groups, and internal departments.
• Ability to speak, read, write, and understand the primary language used in the workplace.

Equal Employment Opportunity

Western Health Advantage is committed to providing equal employment opportunities to employees and applicants based on merit and without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, physical or mental disability, medical condition, genetic information, marital status, ancestry, military or veteran status, or any other basis protected by federal or state law.

Western Health Advantage values and supports the unique talents and strengths each employee brings to our organization. Collaborating with the best and brightest creates a dynamic and fulfilling work experience for our employees—and excellent service for our members.

Western Health Advantage is an Equal Opportunity Employer.