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MAGELLAN HRSC, INC. Clinical Pharmacy Technician II - R00000041569 in Maryland Heights, Missouri

Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.Determines appropriateness for medications. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists. Researches, resolves and documents prior authorization outcomes in pharmacy system.Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician`s office staff, medical management staff and/or pharmacists.Escalates requests to Pharmacist when request requires extensive clinical review or denial.Monitors telephone system to ensure adequate staffing to maintain client services levels.Assesses training needs within the team. Serves as a training resource, mentor and coach to others. Identifies and shares best practices.Demonstrates, advocates and reinforces a positive team environment.Other duties as assigned.Other Job RequirementsResponsibilitiesCPT: Certification/licensure in accordance with state requirements. In the states of Florida, Rhode Island and Michigan, license registration with the Board of Pharmacy is required without exception.National Certification such as PTCB or ExCPT: Certification or the ability to obtain certification within one year of hire. Employees in states which require a Pharmacy Technician certification/registration exam may substitute state certification/registration for the national certification.Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.Excellent written and verbal communication skills.Ability to follow clinical criteria and instructions to approve prior authorization requests.Minimum of 2 years dispensing or retail experience required, or equivalent internal training will be substituted.Ability to identify and trouble-shoot problematic issues.General Job Information TitleClinical Pharmacy Technician IIGrade18Work ExperiencePharmacyEducationGED (Required), High School (Required)License and Certifications - RequiredCPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - PharmacyLicense and Certifications - PreferredMagellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.Equal Opportunity Employerminorities/females/veterans/individuals with disabilities/sexual orientation/gender identity

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