Pharmacy Benefit Technician

This is a fully remote position, open to applicants in Wisconsin.

📋 Description

• Accountable for adhering to the policies and procedures established within the pharmacy department to guarantee that Members receive appropriate medications promptly, cost-effectively, and efficiently.

• Requires proficiency in various computer applications.

• This position entails a considerable amount of time spent on the phone addressing inquiries from Members, pharmacies, and providers regarding pharmacy-related matters such as coverage, prior authorization, step therapy, networks, overrides, and the rationale for denials.

• Assess incoming prior authorization requests and reach out to the provider's office, pharmacies, prior authorization department, or Member to clarify the purpose of the prior authorization and identify any potential missing details.

• Input prior authorizations and formulary exception requests into the referral form.

• Examine Plan policies to ascertain which requests need to be forwarded to the clinical pharmacist team for assessment.

• Will draft initial and benefit denial letters.

• Act as a liaison with the pharmacy benefit manager (PBM) concerning any pharmaceutical questions or issues that may arise.

• Serve as a resource for other departments within the health plan.

• Achieve and uphold all benchmark statistics while in this role.

⛳️ Requirements

• Pharmacy technicians are required to have at least a high school diploma or equivalent.

• Experience in inpatient and retail pharmacy utilization, along with a comprehensive understanding of pharmacy practice, is preferred but not mandatory.

• Familiarity with computers and the ability to work with multiple programs simultaneously is essential.

• Must possess excellent oral and listening skills for effective interoffice communication and interactions with Members or providers.

• Must hold national certification (CPhT designation), either through the Pharmacy Technician Certification Board (PTCB) or the National Healthcare Association (NHA).

• South Dakota: Registration is required within 30 days from the date of hire.

🏝️ Benefits

• Comprehensive health coverage options.

• Opportunities for professional development and growth.

• Competitive salary and performance-based incentives.

• Supportive work environment with a focus on team collaboration.