Pharmacy Technician, Retrospective Case Management

This is a fully remote position, open to applicants in Alabama, +18 more states.

📋 Description

• Oversee designated work queues associated with non-clinical retrospective case management operations, benefit exclusions, formulary and therapeutic substitutions, as well as high-cost case management.

• Liaise with physicians, nurses, and pharmacists to address outstanding case documentation, patient medication histories, and cost information for specialty and traditional medications.

• Conduct initial reviews of retrospective case management for specialty medications in accordance with established policies.

• Assist in high-cost case management operations.

• Engage in the development and maintenance of internal clinical processes.

• Aid in the creation of expanded services to be handled by pharmacy technicians.

• Craft and deliver follow-up communications to physicians pertaining to case management documentation.

• Facilitate peer-to-peer interactions between physicians and pharmacists.

• Act as the primary contact for high-cost case management and retroactive drug utilization cases.

• Coordinate outgoing physician notifications and incoming case documentation.

• Organize queues and manage documents for the pharmacy technician case management tasks.

• Execute retrospective case management for provider denial and low-clinical-acuity cases as identified by clinical policies and guidelines.

• Participate in, promote, and support compliance, people and culture, and educational programs.

• Undertake additional responsibilities as assigned.

⛳️ Requirements

• High school diploma or GED is mandatory.

• A valid Pharmacy Technician license is required.

• Experience in Pharmacy, Hospital, or Managed Care is preferred.

• Knowledge and experience in benefits are preferred.

• Proficiency in Microsoft Excel, PowerPoint, and Word is essential.

• Capability to engage in, adhere to, and support compliance program objectives.

• Ability to consistently interact with colleagues in a cooperative and respectful manner.

• Remote work is available exclusively for residents of Alabama, Colorado, Florida, Georgia, Indiana, Illinois, Iowa, Kansas, Kentucky, Maryland, Minnesota, Missouri, New Hampshire, New Jersey, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Virginia, or Wisconsin.

• Work hours are Monday to Friday, from 8:00 am to 5:00 pm.

🏝️ Benefits

• Comprehensive industry-leading benefits for Health, Dental, and Vision insurance.

• 20 days of paid time off.

• 4 weeks of paid parental leave.

• 9 paid holidays.

• 401K company match of up to 5% with no vesting requirement.

• Adoption Assistance Program.

• Flexible Spending Account.

• Educational Assistance Plan and support for Professional Memberships.

• Referral Bonus Program offering up to $750!

• Fully remote work arrangement.