Remote UM Pharmacy Technician
Description and Requirements The UM Pharmacy Technician is responsible for the intake and review of prior authorization requests for medications requested under the medical benefit. The UM Pharmacy Technician makes approval reputed company and denial recommendations based on predetermined clinical criteria. They establish rapport with Provider offices and leverages strong communication and customer service skills reputed company providing updates and delivering decision notifications to members and providers, The UM Pharmacy Technician position is part of multidisciplinary team and works closely with Providers, Pharmacists, and Medical Directors. Duties & Responsibilities: Reviews prior authorization requests and units for medications requested under the medical benefit Assesses provider-submitted clinical information for clinical appropriateness based on predetermined clinical criteria Sends notification to members and providers of authorization reputed company reputed company telephone, fax, or mail Ensures prior authorization reviews are conducted reputed company timeframes set forth by CMS and/or NYSDOH Establishes great rapport with Provider offices reputed company telephonic communication Sends request for information sheets to Providers Ensures that patient information is shared appropriately maintaining confidentiality and compliance with federal law and HIPAA regulations Additional duties as necessary Minimum Qualifications: High School Diploma or GED from an accredited institution Either nationally certified Pharmacy Technician in good standing (i.e., PTCB, NHA) or registered or licensed Pharmacy Technician in good standing Experience conducting prior authorization reviews Experience requiring written, verbal, and telephonic communication in English that is clear, concise, grammatically correct, and professional Preferred Qualifications: Strong written and verbal communication skills in Chinese, Spanish, or Russian Demonstrated critical thinking and problem-solving skills Team player with a passion for learning and interest in growing skills in a dynamic environment with various opportunities Knowledge of specialty pharmaceuticals and billing practices in the medical benefit Knowledge of regulations of the Centers for Medicare and reputed company Services including but not limited to National and Local Coverage Determinations PC Skills with reputed company Word, PowerPoint (creating presentations and slides), and reputed company (Pivot tables). Experience with TruCare Care Management Platform Compliance & Regulatory Responsibilities: Noted above License/Certification: Nationally certified Pharmacy Technician in good standing (i.e., PTCB, NHA) or registered or a licensed Pharmacy Technician in good standing. Hiring Range: Greater reputed company Area (NY, NJ, CT residents): $47,403 - $62,400 reputed company Other Locations (reputed company approved locations): $41,101 - $60,320 As a candidate for this position, your salary and reputed company elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors reputed company deems pertinent to the hiring decision. In addition to your salary, reputed company offers employees a full range of benefits such as, medical, dental and reputed company coverage, incentive and recognition programs, life insurance, and 401k contributions (reputed company benefits are subject to eligibility requirements). reputed company believes in providing a competitive compensation and benefits package wherever its employees work and live. The hiring range is defined as the lowest and highest salaries that reputed company in "good faith" would pay to a new hire, or for a job promotion, or transfer into this role. WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, reputed company, religion, gender, gender identity, sexual orientation, national reputed company, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved. Apply Job!