Shift Schedule: Monday-Friday (1st shift; shift start times vary)
This position will work virtually. The Ideal candidate must live within 50 miles of one of our Elevance Health PulsePoint locations.
A proud member of the Elevance Health family of companies, CarelonRx (formerly IngenioRx) leverages the power of new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care.
The Pharmacy Tech II 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.
Minimum Requirements:
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.
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.
Preferred Capabilities, Skills, and Experiences:
Call center experience with high call volumes preferred.
Prior authorization experience preferred.
Patient care experience 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.
For candidates working in person or remotely in the below location(s), the salary* range for this specific position is $18.94/hour to $23.68/hour.
Locations: Nevada
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
