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Certified Pharmacy Technician 1
Ref No.: 18-25515
Location: Houston, Texas
Description/Comment:-
Supports comprehensive coordination of Medicaid pharmacy services including intake and processing of Pharmacy Prior Authorization requests.
Promotes and supports quality effectiveness of Healthcare and Pharmacy Services.
High Volume call center and production unit.
Receive inbound calls and fax requests from providers, pharmacies and health plan staff to calls to member to process prior authorization requests.
Utilizes various propriety systems to build, research, process and enter prior authorizations.
Performs non-medical research including eligibility verification, COB, and benefits verification.
Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
Promotes communication, both internally and externally to enhance effectiveness of medication therapy management services.
Protects the confidentiality of member information and adheres to company policies regarding confidentiality.
May communicate with Healthcare Case Managers and Health Plan Staff.
Process requests in compliance with various laws and Client regulations and company policies and procedures.
Sedentary work involving significant periods of sitting, talking, hearing and keying. Work requires visual acuity to perform close inspection of written and computer generated documents as well as dual PC monitors.
May perform clinical research to support prior authorization request.
Promotes communication, both internally and externally to enhance effectiveness of medication therapy management services.
Protects the confidentiality of member information and adheres to company policies regarding confidentiality.
May communicate with Healthcare Case Managers and Health Plan Staff.
Process requests in compliance with various laws and Client regulations and company policies and procedures.
Sedentary work involving significant periods of sitting, talking, hearing and keying. Work requires visual acuity to perform close inspection of written and computer generated documents as well as dual PC monitors.
May perform clinical research to support prior authorization request.

Additional Job Details:
This position requires BOTH a state license and PTCB certification.