Previous Job
Pharmacy Service Health Plan Technician
Ref No.: 18-00540
Location: Washington, DC, District of Columbia
Start Date / End Date: 10/02/2018 to 02/02/2019
The pharmacy technician is expected to improve productivity, enhance responsiveness, allow for growth and differentiation of associates skills, and provide value to the Enterprise.

1. Support day-to-day pharmacy plan operations which includes but is not limited to: Aid other clinical associates with questions about real-time pharmacy concerns and directly enter prior authorizations under the direction of the pharmacist, by having direct access to the claims processing system.

2. Communicate with members, providers, and associates regarding pharmacy benefits.

3. Support Pharmacy related events.

4. Support standard and ad-hoc reporting requests to tightly manage the utilization and cost of the plan. This would include any urgent requests that could be received internally from management or externally from the state.

5. Assist with member and provider communications regarding formulary changes, performing NCQA audits, and coordinating authorizations with the appeals team.

6. Review, support and troubleshoot pharmacy benefit to ensure accurate pharmacy coverage and continuity of care.

7. Analyze data for trends and determine if there areas of interest that require greater focus.

8. Creates and supports an environment which fosters teamwork, cooperation, respect and diversity. Establishes and maintains positive communication and professional demeanor with internal and external business partners at all times.

9. Performs other related duties as assigned.

10. Attends required training on an annual basis.

11. Adheres to Amerihealth Caritas Family of Companies policies and procedures.

1. Drug Therapy Management (DTM) referral, when applicable
2. Website maintenance
3. Calendar maintenance
4. Quarterly Audits (website, call center)
5. Organizational Competencies
a. Business Knowledge
b. Communication
c. Customer Focus
d. Initiative
e. Judgement/ Decision Making
f. Managing & Adapting to Change
g. Professionalism
h. Teamwork
i. Technical Competency
j. Decisiveness
k. Results Oriented

6. Job-specific Competencies
a. Knowledge in pharmacy practices, procedures and precedents; ability to read and understand pharmaceutical terms and information (ie, prior authorization, formulary, day supply, etc.)
b. Has or is able to obtain a state pharmacy technician licensure or certification where applicable (must obtain needed credentials within 3 months unless approved by supervisor)
c. Working knowledge of drug dosage forms, drug strength, generic & trade name equivalent
d. Demonstrates knowledge of Federal & State laws/ regulations regarding provisions of pharmaceutical services
e. Ability to multi-task and prioritize work
f. Ability to comprehend and follow established office routines, policies and procedures
g. Customer service and interpersonal skills
h. Ability to adjust based on business/ department needs
i. Demonstrated courteous and professional behavior
j. Proficient PC skills in a Windows-based environment
k. Excellent oral and written communication skills

Work History
• Minimum of three to five years' work experience (previous retail, hospital, PBM, mail order, long term care, managed care, home infusion pharmacy experience)