AmeriHealth Caritas Pharmacy Services Technician in Philadelphia, Pennsylvania

Pharmacy Services Technician

Location: Philadelphia, PA

Telecommuter?: Yes

ID**: 14476

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 .

Responsibilities:

Under the general supervision of the Pharmacy Manager, the Pharmacy Services Technician I assists in the management of the pharmacy benefit program.

  • Reviews and approves physician inquiries for pre-authorization, appeal and medical necessity requests based on established pharmacy guidelines and contract criteria

  • Supports Fraud and Abuse program system oversight by reviewing medication utilization records. Communicates any suspected fraud discovered, and recommends course of action for Providers where patterns appears outside of guidelines and generally accepted pharmacy standards

  • Maintains and updates internal databases. Enters prior authorizations and other relevant data. Ensures database information and appended files are current and accessible to staff. Generates reports and other information requested on a scheduled/as needed basis.

  • Supports internal staff with assisting plan members in understanding and better utilizing their pharmacy benefits

  • Creates and supports an environment which fosters teamwork, cooperation, respect and diversity.

  • Establishes and maintains positive communication and professional demeanor with internal and external business partners at all times

  • Performs other related duties as assigned

  • Attends required training on an annual basis

  • Adheres to company’s policies and procedures

Education/Experience:

  • High School Diploma or equivalent required

  • Associate’s degree preferred

  • Current PTCB or NCCT certificate required

  • Prefer a minimum one (1) year of current and/or recent PBM, managed care, hospital pharmacy, LTC pharmacy, Home Infusion pharmacy, retail pharmacy experience

  • Minimum 35 words per minute typing speed

EOE Minorities/Females/Protected Veterans/Disabled