Pharmacy Technician - Prior Authorization Specialist II or III

Job Description

Job Description

About Us :

Arizona Liver Health (ALH) is dedicated to driving high standards of care and advancing medical innovation through leading clinical trials, ensuring patient safety and regulatory compliance, and generating high-quality clinical data. Our network of multiphase, multitherapeutic research, standard of care, and VEN Centers sites is staffed by skilled providers, research, clinic, pharmacy, and patient outreach professionals. ALH operates state-of-the-art facilities and programs to meet the evolving needs of clinical research and overall patient treatment.

Job Summary :

The Pharmacy Technician - Prior Authorization Specialist II or III is a crucial part of the healthcare team to assist patients in providing specialized, complex medications for their liver disease and / or condition. This includes obtaining authorizations, navigating financial assistance options, and working with patients, payors, and pharmacies. The prior authorization specialist takes care of the prescription from the time it is ordered to ensuring the patient receives the medication(s).

Schedule : Onsite in Mesa, AZ, Full-Time, 8am-5pm Monday-Friday

Compensation : $23 - $32 per hour, depending on experience and qualifications

Essential job functions / duties

Reasonable accommodation may be made to enable individuals with disabilities to perform these essential functions.

• Assure all prior authorizations (PA) requirements are complete.
• Facilitate labs / immunization completion for patient payor compliance.
• Interact professionally with patients, peers, and other outside vendors as required.
• Assists in training new pharmacy staff along with level III PA Specialists on organizational processes and compliance procedures
• Manage pharmacy software for patient compliance with treatment.
• Supports comprehensive coordination of commercial, Medicaid and / or Medicare pharmacy services including intake and processing of pharmacy authorization requests.
• Promotes and supports quality effectiveness of healthcare and Pharmacy Services within clinical setting
• Evaluates, aids in authorizing approval, and communicates decisions for pharmacy requests according to clinic process
• Evaluates and aids in authorizing approval of pharmacy requests received by telephone, facsimile, and / or other means using client clinical criteria
• Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements with minimal supervision
• Process requests in compliance with various laws and CMS regulations and company policies and procedures
• May communicate with payors, external pharmacies, patients, case managers, electronic PA platforms
• Promotes communication, both internally and externally, to enhance effectiveness of medication therapy management services
• Escalates requests to Nurse Case Manager when request requires extensive clinical review or denial

Knowledge / Skills / Abilities Required

Education, credentials, and / or trainings required :

Supervisory responsibilities

Work environment

Physical demands

Travel Requirements

Benefits & Perks :

Work authorization / security clearance requirements

Must have valid documentation and authorization to work in the U.S.

Our company requires COVID-19 vaccinations for all current and future employees. Exemptions can be requested for those with a reasonable health or a religious / sincerely -held belief accommodation.

Affirmative Action / EEO statement

It is the policy of the Institute for Liver Health DBA Arizona Liver Health and Arizona Clinical Trials to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information or any other protected characteristic under applicable law. This policy relates to all phases of employment, including, but not limited to, recruiting, employment, placement, promotion, transfer, demotion, reduction of workforce and termination, rates of pay or other forms of compensation, selection for training, the use of all facilities, and participation in all company-sponsored employee activities. Provisions in applicable laws providing for bona fide occupational qualifications, business necessity or age limitations will be adhered to by the company where appropriate.

Other duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Other responsibilities may be communicated directly by the reporting manager / supervisor. Duties, responsibilities, and activities may change. Company reserves the right to adjust role scope with or without notice.

Notice to Staffing Agencies : It is our policy that any and all contact with third party staffing or recruitment vendors come through our Talent Acquisition Team directly. We have an established and preferred network of contracted partners that we engage if and when we deem it necessary. We request that staffing agencies refrain from repeatedly contacting our hiring managers or employees directly. Unsolicited resumes, onsite solicitations, and inquiries will not be considered or responded to. Overly persistent or pushy inquires may also be blocked across our network as spam. Thank you for your understanding and cooperation.