Pharmacy Technician

Why Choose Jefferson Health Plans?

We are an award-winning, not-for-profit health maintenance organization. We are committed to creating a community where everyone belongs, acknowledges, and celebrates diversity and has opportunities to grow to their fullest potential.

We offer Medicaid, Medicare, and Children’s Health Insurance Program (CHIP) plans that include special benefits to improve the health and wellness of our members.

We’re also committed to boosting the health of our community through outreach, education, and events. Founded over 35 years ago, Health Partners Plans continually develops new ways to encourage better health outcomes and has received national recognition for our innovations in managed care.

While this job currently provides a flexible remote option, due to in-office meetings, training as required, or other business needs, our employees are to be residents of PA or the nearby states of DE or NJ.

Perks of Jefferson Health Plans and why you will love it here :

• Competitive Compensation Packages including 401(k) Savings Plan with Company Match and Profit Sharing
• Flextime and Work-at-Home Options
• Benefits & Wellness Program including generous Time Off
• Impact on the communities we service

We are seeking a talented and enthusiastic Pharmacy Technician to join our team!

Works under general supervision and answers calls from physician and pharmacy providers through pharmacy hotline. Assist in administering prior authorizations according to established guidelines, assist Clinical Pharmacists in case review process, and assist with oversight of recipient restriction program (RRP).

Actively participate in physician education & outreach program and perform claims analysis for drug utilization review (DUR), fraud, abuse, and over-utilization.

As the Pharmacy Technician, your daily duties may include :

• Assist department in reaching call center goals based on standards of productivity (percent of calls answered within 30 seconds, percent of abandoned calls).
• Assist department in reaching call center goals based on standards of quality (providing accurate information to physicians and pharmacies)
• Maintain knowledge of different pharmacy benefit packages under Medicaid and Medicare to be communicated to providers and other departments
• Assist Clinical Pharmacists in handling member reimbursements
• Assist Clinical Pharmacists in responding to physician and pharmacy providers’ telephone calls, to provide safe and effective formulary alternatives, resolve processing errors (i.

e. eligibility, plans limits exceeded, national drug code (NDC) not covered, refill too soon, etc.) and handle reimbursement issues.

• Assist Clinical Pharmacists in reviewing clinical cases including researching previous medication history, obtaining additional information as it pertains to the case, notifying physician’s office of approval and / or denial of prior authorization request, generating letters for approved medication requests, and expedite prior authorization requests.
• Interact with other departments including Member Relations, Special Needs Unit, Complaints and Grievances, Disease Management, and Utilization Management;

assisting in resolving pharmacy issues.

• Conduct clinical DUR on pharmacy claims and make recommendations for recipient restriction program.
• Provide ideas and suggestions to help improve quality and flow of pharmacy department.
• May perform other duties as assigned.

Qualifications

• High school diploma and 1-2 years experience in pharmacy.
• Pharmacy Technician certification required.

Skills, We Value :

• Familiar with a managed care and delegated pharmacy services.
• Excellent written and oral communication skills.
• Self motivated and a team player.
• Proficient in Excel and relational databases such as MHS, On-Contact and Argus
30+ days ago