Clinical Pharmacy Technician

Description Who We Are - Motivated by Purpose.

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Founded in 1983, we’re a clinically-driven, tech-enabled utilization management company offering expert clinical reviews, regulatory guidance, and actionable insights to healthcare organizations.

Excellence starts with our people.

WE OFFER A competitive compensation package.

Beneficios

include healthcare, vision and dental insurance, a generous 401k match, paid vacation, personal time, and holidays

Growth and training opportunities.

A team atmosphere with fun events and prizes scheduled throughout the year.

Position Summary Our Clinical Pharmacy Technician processes prior authorization requests in accordance with standards for accuracy, timeliness, productivity, and client performance commitments.

• Performs analysis, obtains information, and enters prior authorization data necessary for claims adjudication.

Utilizes reasoning.

Habilidades

to identify missing information and make prior authorization processing determinations based on clinical protocols and client guidelines (approve, pend, refer for clinical decision, etc.)

Interacts with internal and external customers to provide and obtain information and ensures the delivery of outstanding service and quality.

Roles Process and finalize PA requests within clients’ turnaround time (TAT) and Performance Guarantees (PGs) utilizing guidelines.

  Accountable for achieving prior authorization processing productivity and accuracy standards Major.

Responsabilidades

or Assigned Duties Enter prior authorizations into the system and prioritize requests.  Check formulary alternatives and review tried and failed medications

Utilize drug references and verify the drug being requested is indicated and approved for the condition.

  Document all related information regarding the PA approval or non-approval.

  Conform to defined roles & responsibilities and rules of engagement between prior authorization processing and clinical decision-making.

Partner with ass.