Job Information
Elevance Health Pharmacy Technician II- Escalations in TUCSON, Arizona
Pharmacy Technician II- Escalations (Pharmacy Tech II)
Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles within our Mason, OH, Grand Prairie, TX, or Tucson, AZ, PulsePoint locations.
CarelonRx Pharmacy is now part of CarelonRx (formerly IngenioRx), a proud member of the Elevance Health family of companies. The CarelonRx Home Delivery Pharmacy will deliver digital first pharmacy experience that is convenient, simpler to use, and more affordable to patients and payers. Our Pharmacy model focuses on whole person care, providing the best member experience to drive adherence, affordability, and improved overall health outcomes by putting the patient first.
The Pharmacy Technician II- Escalations is responsible for the interpretation and data entry of moderately complex prescriptions, prior authorization processing, and troubleshooting adjudication issues.
How you will make an impact:
Verifies member information and inputs data for the pharmacists.
Educates members on pharmacy based rules related to prescriptions and medication resources or assistance programs.
Processes prior authorization requests from physicians' offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations.
Provides resolution to grievances and appeals issues.
Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits.
Generates reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports.
Maintains record keeping of prior authorizations, rebates, and monthly reports.
Collaborates with account management and client facing partners to resolve Escalations that occur in the normal operations of the Pharmacy. This may include working with patients, providers, and internal business partners to ensure Client and Patient issues are resolved.
Minimum Requirements:
Requires an active, professional license, if required by state law, State Pharmacy Technician Certification or National Certification based on applicable state(s) requirements, to practice as a Pharmacy Technician within the scope of practice in a state or territory of the United States.
Requires H.S. diploma or equivalent and minimum of 2 years of pharmacy experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities, and Experiences:
- Experience with EnterpriseRx, Patient Services Tool, and COS preferred.
For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.