Utilization Review Pharmacy Technician

Prime Therapeutics; Lansing (MI); On-site; USD 32,000 - 51,000; Full time

Job summary

Prime Therapeutics in Lansing, MI is seeking an Initial Review Pharmacy Technician to support utilization management and medication reimbursement decisions for health plans. You will review prospective and retrospective requests, gather clinical information from providers, and coordinate with internal teams to ensure timely processing of medications.

The role requires Pharmacy Technician licensure, 2+ years of experience, and the ability to navigate complex formularies; salary ranges depend on

Qualifications

• Associate's degree in or equivalent combination of education and/or work experience; HS diploma or GED required.
• 2+ years of Pharmacy Experience.
• CPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy

Responsibilities

• Reviews pertinent patient information and checks appropriateness using clinical criteria; makes approval recommendations.
• Upholds clinical integrity by participating in ongoing training and ensuring quality performance.
• Communicates with physicians and pharmacies to obtain pertinent clinical history for reimbursement decisions.
• Document communications and maintain edits/data elements supporting the edits.

Skills

Excellent verbal and written communic@

Strong team orientation

Analytic skills

Education

Associate's degree or equivalent

Bachelor's degree in Science/Health/Medical or related field

Tools

Active pharmacy technician licensure

National certification (PTCB or ExCPT)

Job description

Prime Therapeutics in Lansing, MI is seeking an Initial Review Pharmacy Technician to support utilization management and medication reimbursement decisions for health plans. You will review prospective and retrospective requests, gather clinical information from providers, and coordinate with internal teams to ensure timely processing of medications.

The role requires Pharmacy Technician licensure, 2+ years of experience, and the ability to navigate complex formularies; salary ranges depend on