AmeriHealth Caritas Jobs

Job Information

AmeriHealth Caritas Manager, Pharmacy Prior Authorization Technician in Nationwide, United States

Manager, Pharmacy Prior Authorization Technician

Location: Nationwide, US

Primary Job Function: Pharmacy

ID**: 19075

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com .

PerformRxis a Pharmacy Benefits Manager (PBM) dedicated to clinical culture, boutique service and holistic solutions. Our mission is to help customers, doctors and patients use effective medication therapy to improve health and wellness. For more than 15 years, our focus has been on providing optimal service through a clinical culture that seeks to provide members with high quality care while ensuring our partners receive favorable costs. That culture is reflected in our employees - more than 80 percent of our staff members are Pharmacists and Pharmacy Technicians - and in the services we provide.

PerformRxis headquartered in Philadelphia with offices on both coasts, leading to better pharmacy benefit management across the nation. Our dedication to innovation and to providing the most efficacious outcomes is the core of our clinical culture and is the heart of PerformRx. PerformRx is a subsidiary of the AmeriHealth Caritas Family of Companies.

Repsonsibilities:

The incumbent manages Prior Authorization Technician activities in conjunction with working collaboratively with other areas under the direction of the Director, Pharmacy Utilization Management to optimize utilization management, prior authorization and coverage determination services. Focuses on operational excellence and develops strategies to increase operational efficiencies while applying clinical programs. Promotes development of new concepts, propose modification to existing prior authorization program or s special projects as appropriate. Researches and implements best practices with respect to Prior Authorization and benchmark PerformRx against peer industry group.

Education/ Experience:

  • High School diploma or equivalent is required

  • Bachelor of Science degree in healthcare field, business, or related field or equivalent preferred

  • Active/current National Pharmacy Technician Certification (ExCPT, PTCB or NCCT) is required

  • Minimum two (2) years of Pharmacy Benefit Management (PBM) and staff management experience required

  • Minimum five (5) years of pharmacy experience required

  • Working knowledge of medical terminology, pharmaceutical terminology and practices

  • Ability to effectively motivate, delegate, and supervise team

  • Ability to interface with all levels of management

  • Ability to collaborate inter and intra departmentally

  • Strong organizational, problem solving and time management skills

  • Ability to handle multiple priorities and projects independently

  • Effective communication (listening, verbal and written) skills

  • Adheres to plan policies and procedures

  • Proficient PC skills in a Windows based environment

  • Attends required training on an annual basis

EOE Minorities/Females/Protected Veterans/Disabled

DirectEmployers