Pharmacy Technician - Prior Auth Part B

Company: Centene Corporation
Location: Pompano Beach
Posted on: March 20, 2023

Job Description:

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose: The Pharmacy Technician may perform duties in one or more of the following areas: Formulary Management, Pharmacy Audit and Recovery, Pharmacy Service Center, Medicare Part D/Part B, Appeals, Medicare Part D Operations and State Health Programs Pharmacy Operations or Prior Authorization. Using established company guidelines, the Pharmacy Technician reviews requests made by physicians, medical groups, pharmacies and members for the use of prescription drugs and pharmacy benefits. The technician researches and resolves questions, problems or issues. May consult with Clinical Pharmacists or Regional Medical Director on related issues.

Prior Authorization Medicare Part D and Part B
Tracks and triage coverage determination and/or prior authorization requests submitted from providers and determine if a pharmacist review is required

Obtains verbal authorizations and request detailed clinical information from prescribers

Approves coverage determination and/or prior authorization requests based on defined criteria

Enters and documents coverage determination and/or prior authorization request decisions into the PBM system and notify providers and/or members

Responds to client inquiries regarding authorization approvals and PBM online applications

Refers coverage determination requests for specialty drugs to delegated vendor or client for processing

Contacts providers for additional information to facilitate coverage determination reviews

Notifies physicians, providers, and members of coverage determination request decisions

Education/Experience: High School diploma or GED required. 1 year Pharmacy Technician experience. Customer Service/retail experience preferred

License/Certification: Valid Pharmacy Technician License preferred.
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Keywords: Centene Corporation, Pompano Beach , Pharmacy Technician - Prior Auth Part B, Professions , Pompano Beach, Florida