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Pharmacy Technician - Prior Authorization Focus
Columbia, South Carolina · Contract
Sponsorship not specifiedDetected 1 day ago
Customer SupportPharmacologyPharmacy PracticeResearchCommunicationCritical Thinking
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Entry-level history0
PERM / green-card track0
Lottery odds40
Fits your clock70
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About the role
- Summary Responsible for setting up cases for pharmacy authorization requests and performing pharmacy reviews as per established criteria.
- Participates in quality control and/or quality improvement activities.
- Description Why should you join the BlueCross BlueShield of South Carolina family of companies?
Responsibilities
- Establishes and maintains effective relationships with providers, members and internal contacts.
- We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
- Receives and builds cases in the various applications for pharmacy authorization requests.
- Researches, resolves and documents outcomes in pharmacy system.
Requirements
- 3 years pharmacy technician experience.
- Participates in all Required Licenses and Certificates.
- Required Work Experience: 3 years pharmacy technician experience.
- Required Skills and Abilities: Working knowledge of pharmaceutical claims, language, drug usage and generic substitution practices.
Nice to have
- Preferred Work Experience: 3 years-pharmacy experience in managed care setting or PBM.
Skills
- Working knowledge of pharmaceutical claims, language, drug usage and generic substitution practices.
- Demonstrated customer service and organizational skills.
- Demonstrated proficiency in spelling, punctuation, and grammar skills.
- Analytical or critical thinking skills.
- Ability to handle confidential or sensitive information with discretion.
- Attention to detail and the ability to handle multiple demands and balance multiple priorities in a fast-paced environment.
- Ability to remain in a stationary position and operate a computer.
- Required Software and Other Tools:
- Required Licenses and Certificates:
- Registered Pharmacy Technician with the applicable state Board of Pharmacy and Certified Pharmacy Technician.
- We Prefer That You Have The Following:
Compensation
- This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.
Benefits
- Subsidized health plans, dental and vision coverage
- 401k retirement savings plan with company match
- Life Insurance
- Paid Time Off (PTO)
- Education Assistance
- Requests additional information from providers including confidential medical history and prior drug therapy, in order to properly evaluate the request.
- Communicates selected authorization criteria, pharmacy benefit coverage, formulary alternatives and/or Pharmacy Management program policies and procedures to pharmacy providers, members and internal contacts.
- Required Education: High School Diploma or equivalent
- Our Comprehensive Benefits Package Includes The Following:
- We offer our employees great benefits and rewards.
- You will be eligible to participate in our benefits program the first of the month following 28 days of employment.
- On-site cafeterias and fitness centers in major locations
Company info
- Responsible for setting up cases for pharmacy authorization requests and performing pharmacy reviews as per established criteria.
- Maintains the timely, complete, and accurate processing of authorization requests by interfacing with internal and external customers and the Pharmacy Benefit Manager (PBM) to resolve issues that may arise in the provision of pharmacy services.
- Processes determination letters and documents decisions using indicated protocol or clinical guidelines.
- This position is full-time (40-hours/week) Monday-Friday in a typical office environment.
- You will work an 8-hour shift between the hours of 7am - 7pm.
- This position is eligible for hybrid work after the training period.
- This role is located at 4101 Percival Road, Columbia, SC 29229.
- There is the expectation of rotating weekends and holidays as well.
Equal opportunity
- BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status.
- Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans.
- It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.
- We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.
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