Pharmacy Technician

Immediate need for a talented Pharmacy Technician.This is a 03 months Contract to hire opportunity with potential to conversion and is PA, NJ or DE(Remote). Please review the job description below and contact me ASAP if you are interested.

Job Diva ID:  26-00278

Pay Range: $24/hr - $27/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities

• Applies critical thinking and judgement skills based on advanced medical knowledge to cases utilizing specified resources and guidelines to make case determination. 
• Utilizes resources such as Care Management Policy, Medical Policy, MicroMedex and Electronic Desk References to determine the medical appropriateness of the proposed plan. 
• Contacts servicing providers regarding treatment plans/plan of care and clarifies medical need for services.
• Notifies ordering providers and Specialty Pharmacy Vendor or approved authorization to arrange shipment of medications to the office.
• Reviews treatment plans/plan of care with provider for requested medications, clarifying medical information with provider if needed.
• Identifies and refers cases where medical necessity criteria are not established to the Clinical Care Coordinator for further evaluation determination.
• Ensures request is covered within the member’s benefit plan.    
• Ensures utilization decisions are compliant with state, federal and accreditation regulations.
• Meets or exceeds regulatory turnaround time and departmental productivity goals when processing referral/authorization requests.
• Ensures that all key functions are documented via Care Management and Coordination Policy.
• Maintains the integrity of the system information by timely, accurate data entry.
• Performs additional duties assigned.

Key Requirements and Technology Experience: 

• Must be Certfied Pharmacy Technician
• At least 2 yrs experience preferred in Utilization Review or Utilization Mgt experience

Our client is a leading Health Insurance Industry , and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

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