Pharmacy Technician II - MCP Clinical Liaison - Remote
At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.
Job Posting Title
Pharmacy Technician II - MCP Clinical Liaison - Remote
Job Description
Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.
Responsibilities
-
Determines appropriateness for medications. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists. Researches, resolves and documents prior authorization outcomes in pharmacy system.
-
Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician`s office staff, medical management staff and/or pharmacists.
-
Escalates requests to Pharmacist when request requires extensive clinical review or denial.
-
Monitors telephone system to ensure adequate staffing to maintain client services levels.
-
Assesses training needs within the team. Serves as a training resource, mentor and coach to others. Identifies and shares best practices.
-
Demonstrates, advocates and reinforces a positive team environment.
-
Other duties as assigned.
Minimum Qualifications
-
GED or High School Diploma Required
-
Required CPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy
-
2+ years Pharmacy
Must be eligible to work in the United States without the need for work visa or residency sponsorship
Additional Qualifications
-
Must have an active pharmacy technician licensure or registration in accordance with state requirements.
-
If state does not require an exam for licensure/registration, must possess both active pharmacy technician licensure or registration in accordance with state requirements AND an active national certification (e.g., PTCB or ExCPT).
-
In states that do not require licensure or registration, must have an active national certification (e.g., PTCB or ExCPT).
-
Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.
-
In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).
-
Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.
-
Excellent written and verbal communication skills.
-
Ability to follow clinical criteria and instructions to approve prior authorization requests.
-
Minimum of 2 years dispensing or retail experience required, or equivalent internal training will be substituted.
-
Ability to identify and trouble-shoot problematic issues.
Preferred Qualifications
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures
Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.
Potential pay for this position ranges from $19.23 - $28.85 based on experience and skills.
To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page ( and click on the "Benefits at a glance" button for more detail.
Prime Therapeutics LLC?is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law. _?
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer._
Positions will be posted for a minimum of five consecutive workdays.
At Prime Therapeutics (Prime), we are a different kind of PBM. We're reimagining pharmacy solutions to provide the care we would want for our loved ones. That purpose energizes our team and creates limitless opportunities to make a difference.
We know that people make all the difference. If you're ready for a purpose-driven career and are passionate about simplifying health care, let's build the future of pharmacy together.
Prime Therapeutics LLC?is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to?race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law. ?? ?
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1.866.469.1257 or email [email protected].
Recommended Jobs
Ambulatory Services Representative III (Belkin Breast Center, 40 Hours, Days)(SEIU)
POSITION SUMMARY: The incumbent is responsible for coordinating all the functions and activities related to patient access including, but not limited to: operation room (O.R.) scheduling, front …
Healthcare Administrative Manager - $35/hour
Healthcare Administrative Manager - $35/hour We are seeking an experienced Healthcare Administrative Manager to oversee daily operations. The ideal candidate will bring strong organizational and l…
Manufacturing Associate I
Job Responsibilities: The candidate will interact with auto/manual equipment, set-up, changeover and clean various automated and manual packaging equipment in strict accordance with SOP’s, Good Ma…
Senior Principal Scientist, Oncology Translational Science and Clinical Biomarkers
Job Description Senior Principal Scientist (Sr Director), Oncology Translational Science and Clinical Biomarkers: Our Company's Oncology organization is dedicated to delivering breakthrough i…
Registered Nurse - Hospice Palliative Care
Seeking a compassionate RN specializing in Hospice Palliative Care in Fall River, MA, earning $2,842/week. Provide expert end-of-life care, managing pain and symptoms with a holistic approach. A…
Restaurant Manager
Do you want to work for a fun, fast paced and growing restaurant brand? 110 Grill Chelmsford is seeking Restaurant Managers to join our team! You will be responsible for providing guests with a memor…
Entry-Level Freight Dispatcher (Remote) - Earn $2,200 to $3,000 Weekly ($114,400-$156,000 Annually)
Entry-Level Freight Dispatcher (Remote) – Earn $2,200 to $3,000 Weekly ($114,400–$156,000 Annually) We are hiring motivated individuals to join our logistics team as Freight Dispatchers. This is a …
Gastroenterologist -large multispecialty group, outpatient GI
A thriving 120-physician multispecialty group healthcare group is seeking a Gastroenterologist in the Fall River, MA area! 1h from Boston, Live in Barrington, RI - Sharon, Easton Dartmouth or Westpor…
Director, Vector Technical Program Lead
Working with Us Challenging. Meaningful. Life-changing. Those aren't words that are usually associated with a job. But working at Bristol Myers Squibb is anything but usual. Here, uniquely inte…