POSITION TITLE: Pharmacy Technician DEPARTMENT: Pharmacy REPORTS TO: Manager of Pharmacy Operations HOURS: 37.5 FLSA: Non-Exempt
SALARY GRADE: 10
This Pharmacy Technician reports to the Manager of Pharmacy Operations and is responsible for conducting and coordinating multiple facets of the prescription drug prior authorization (PA) process and coordination and completion of administrative tasks associated with the Pharmacy Department operation. The duties associated with this position include PA order entry, updating PA’s within the Pharmacy claims system, tracking and reporting of PA activity and processing of PA notifications to Providers and patients. The position is responsible for preparation of meeting materials and oversight of logistics for the Pharmacy and Therapeutics (P&T) Committee meetings. The position completes other administrative tasks such as drafting meeting minutes; preparing, collating and distributing pharmacy related mailings to members and Providers; ordering office supplies and booking meetings rooms.
The position requires a working knowledge and familiarity with prescription drugs. The position works closely with Neighborhood’s Medical Management, Pharmacist and Customer Service staff. The position requires excellent verbal communication skills and a demonstrated ability to work in an organized, timely, efficient and thorough manner.
Required: - Experience in Pharmacy, Pharmacy administration or Pharmacy claims processing - Independent in problem solving and task management - Strong computer skills (spreadsheets, word processing) - Ability to manage multiple tasks and deadlines - Strong verbal communication skills
- Certified Pharmacy Technician
Duties and Responsibilities: Responsibilities include, but are not limited to the following:
- Processing of Pharmacy Prior Authorization (PA) requests - Uses PA software application to receive and log PA requests submitted by prescribing Providers - Reviews PA request for completeness and obtains additional information from prescribing Provider and/or dispensing Pharmacy as needed - Prioritizes PA requests according to the urgency of PA decision (urgent vs. non urgent) - Forwards PA requests to Neighborhood Pharmacist for review - Documents PA decision in PA software application and Pharmacy claims system - Notifies dispensing Pharmacy of PA decision - Prepares and distributes PA denial letters to Members and Providers - Confirms all faxes are transmitted correctly - Processing of PA Appeals - Receives written and verbal PA appeals from prescribing Providers - Uses claims software application to log and record pertinent information related to PA appeals - Obtains additional information related to appeal from prescribing Provider and/or dispensing hharmacy, as needed - Prepares and sends appropriate written notices to prescribing Provider and patient - Forwards appeal to Neighborhood Physician Reviewer for review - Documents appeal decision in Neighborhood claims system and Pharmacy claims system - Prepares and distributes appeal denial letters to Members and Providers - Notifies dispensing Pharmacy of appeals decision - Maintains records and files associated with PA requests and PA appeals - Completes documentation of PA and appeal decisions in appropriate claims system - Maintains hardcopy files for PA and appeal documents - Compiles monthly statistic related to PA requests and appeals and prepares monthly report - Prepare hardcopy documents for P&T meeting notebooks - Collate and organize hardcopy documents for P&T meeting notebooks - Distribute P&T meeting notebooks - Draft P&T meeting minutes - Process payments for P&T Members - Book meeting room space to P&T and other department meetings - Coordinate ordering of department supplies including food for P&T meeting - Assist Pharmacists in the preparation and distribution of Pharmacy mailings/reports to Providers and members - Attends P&T and Pre P&T meetings - Processes Pharmacy Home Program enrollment documents - Other duties as assigned by Director of Pharmacy or Manager of Pharmacy Operations
Neighborhood is an EOE M/F/D/V and an E-Verify Employer.