Senior Pharmacy Technician – Call Center

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

📋 Description

• Oversee Medicaid and/or Medicare pharmacy services, which includes the intake and processing of pharmacy authorization requests.

• Advocate for and enhance the quality and effectiveness of healthcare and Pharmacy Services.

• Assess, authorize, and convey pharmacy request decisions in line with clinical guidelines.

• Review pharmacy requests received through telephone, facsimile, and other channels using client clinical criteria.

• Evaluate the appropriateness of medications and relay decisions to physicians, medical management staff, members, and pharmacists.

• Conduct clinical and non-medical research, including eligibility checks, COB, and benefits verification.

• Ensure accurate documentation that complies with risk management, regulatory, and accreditation standards.

• Process requests in accordance with laws, CMS regulations, and company policies.

• Communicate with Aetna Case Managers, Health Plan Staff, External Pharmacies, and Health Care Providers.

• Foster internal and external communication to improve medication therapy management services.

• Refer requests that need extensive clinical review or denial to a Pharmacist.

• Carry out sedentary work that involves considerable periods of sitting, talking, hearing, and data entry.

⛳️ Requirements

• A National Pharmacy Technician certification and a current, valid Home State License are mandatory.

• Expertise in computerized pharmacy systems and software applications is essential.

• Strong verbal and written communication abilities are required.

• Familiarity with Windows-based software applications is necessary.

• Experience in using proprietary systems to build, research, process, and enter requests is preferred.

• Capability to maintain the confidentiality of member information and comply with company confidentiality policies is essential.

• A high school diploma or G.E.D. is required.

• Experience in a high-volume call center and production unit is advantageous.

• Background in retail, hospital, facility, or call center settings is preferred.

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources supporting physical, emotional, and financial well-being.

• Eligibility for CVS Health bonus, commission, or short-term incentive programs.