Elevance Health - Mason, OH

posted 6 days ago

Full-time - Entry Level
Mason, OH
11-50 employees
Insurance Carriers and Related Activities

About the position

The Pharmacy Tech II at Elevance Health is responsible for interpreting and entering moderately complex prescriptions, processing prior authorizations, and resolving adjudication issues. This role plays a crucial part in ensuring compliance with pharmacy regulations and providing support to members and healthcare providers.

Responsibilities

  • 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.

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.
  • Strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Benefits

  • Merit increases
  • Paid holidays
  • Paid Time Off
  • Incentive bonus programs
  • Medical insurance
  • Dental insurance
  • Vision insurance
  • Short and long term disability benefits
  • 401(k) with matching
  • Stock purchase plan
  • Life insurance
  • Wellness programs
  • Financial education resources
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