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Job Discription
*Must be a current CPhT.
POSITION SUMMARY
The primary responsibility of the Prior Authorization Pharmacy Technician is to review the day-to-day submissions of prior authorizations. The Pharmacy Technician will also have the knowledge base of what clinical documentation is required. This position ensures that all requests are handled promptly, efficiently, and accurately to ensure quality services are provided. The role will require direct contact with health care staff, retail and mail order pharmacies. The Pharmacy Technician will use experience to anticipate potential problems before they occur and know when to elevate to the Account Manager, Clinical Pharmacist or Program Manager for final resolution.
ESSENTIAL FUNCTIONS
Reasonable Accommodations Statement
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.
Essential Functions Statement(s)
- Respond to all Prior Authorization requests.
- Have the ability to respond to inquiries and request clinical documentation via phone and e-mail.
- Populate database to insure Business Day 1 and 3 contract compliance requirements are met, and insure telephone, e-mail and faxes are properly identified, and are completed and closed.
- Create, organize and maintain files.
- Communicate with internal and external customers, to include: the USMS Account Managers, Clinical Pharmacist, Detention Facilities’ healthcare staff, retail and mail order pharmacies.
- Participate in staff meetings.
- Communicate with the Customer Care Center.
- Provide input as needed, regarding prior authorizations.
- Responsible for demonstrating a knowledge base required for clinical documentation, drug information databases, pharmacy law, and customer satisfaction.
- Maintain open lines of communication.
- Other job related duties as assigned.
POSITION QUALIFICATIONS
Competency Statement(s)
- Accuracy – Ability to perform work accurately and thoroughly.
- Active Listening – Ability to actively attend to, convey, and understand the comments and questions of others.
- Adaptability – Ability to adapt to change in the workplace.
- Analytical Skills – Ability to use thinking and reasoning to solve a problem.
- Communication, Oral – Ability to communicate effectively with others using the spoken word.
- Communication, Written – Ability to communicate in writing clearly and concisely.
- Customer Oriented – Ability to take care of the customers’ needs while following company procedures.
- Organized – Possessing the trait of being organized or following a systematic method of performing a task.
- Decision Making – Ability to make decisions while following company procedures.
- Relationship Building – Ability to effectively build relationships with customers and co-workers.
- Detail Oriented – Ability to pay attention to the minute details of a task.
- Judgment – The ability to formulate a sound decision using the available information.
- Deductive Reasoning – Ability to apply principles of logical or scientific thinking to a wide range of intellectual and practical problems.
- Job Knowledge – Knowledge of job and policies/procedures that apply to one’s job.
- Interpersonal – Ability to get along well with a variety of personalities and individuals.
REQUIRED SKILLS & ABILITIES
Education: High School Degree required
Current CPhT required
Experience: Minimum of one to three years’ experience as a pharmacy technician.
Education: High School Degree required
Current CPhT required
Experience: Minimum of one to three years’ experience as a pharmacy technician.
Computer Skills: Microsoft Office (Word, PowerPoint, Excel, Access, Outlook), and Internet
Certificates & Licenses: Current unrestricted Texas State Pharmacy Technician License. Valid state issued driver’s license.
Other Requirements: Ability to fluently speak, read, and write in English. Must be detailed oriented, able to multi-task, communicate efficiently and function in a team-oriented environment.
Certificates & Licenses: Current unrestricted Texas State Pharmacy Technician License. Valid state issued driver’s license.
Other Requirements: Ability to fluently speak, read, and write in English. Must be detailed oriented, able to multi-task, communicate efficiently and function in a team-oriented environment.
PHYSICAL DEMANDS
| Physical Demands | Lift/Carry | ||||||||||||||||||||||||||||||
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| N (Not Applicable) | Activity is not applicable to this occupation. |
| O (Occasionally) | Occupation requires this activity up to 33% of the time (0 – 2.5+ hrs/day) |
| F (Frequently) | Occupation requires this activity from 33% – 66% of the time (2.5 – 5.5+ hrs/day) |
| C (Constantly) | Occupation requires this activity more than 66% of the time (5.5+ hrs/day) |
Other Physical Requirements
Vision (Near, Distance, Peripheral, Depth Perception)
Sense of Sound (Corrected within normal decibel range)
Sense of Touch
Sense of Sound (Corrected within normal decibel range)
Sense of Touch
WORK ENVIRONMENT
General office environment. Work is generally sedentary in nature, but may require standing and walking for up to 10% of the time. The working environment is generally favorable. Lighting and temperature are adequate, and there are no hazardous or unpleasant conditions caused by noise, dust, etc. Work is generally performed within an office environment, with standard office equipment available.
Heritage Health Solutions, Inc. is an equal opportunity employer. We provide equal employment opportunities to all qualified employees and applicants for employment without regard to race, religion, sex, age, marital status, national origin, sexual orientation, disability or any other legally protected status. We prohibit discrimination in decisions concerning recruitment, hiring, compensation, benefits, training, termination, promotions, or any other condition of employment or career development.
