Health Plan of San Joaquin French Camp, CA
Under direct supervision, the Pharmacy Technician is responsible for screening and inputting pharmacy authorizations.
- Reviews requests to ensure complete and accurate documentation.
- Obtains and/or clarifies information using a variety of internal and external resources; follows up as required.
- Approves routine authorizations.
- Completes projects assigned by the plan Pharmacist.
- Escalates non-standard items/request to Pharmacy Director or Pharmacist.
- Enters data into appropriate HPSJ system(s).
- Prepares and sends required correspondence.
- Maintains and updates file systems.
- Monitors authorization inventory to ensure timely completion; requests back-up as needed.
- Screens Pharmacy Prior authorizations (PA) to determine if they meet first-level PA criteria.
- Partner with IPs to enter authorizations in the PBMs system
- Resolves adjudication issues; escalates as required.
- Produces work that is accurate and complete.
- Produces the appropriate amount of work.
- Actively learns through experimentation when tackling new problems, using both successes and failures to learn.
- Rebounds from setbacks and adversity when facing difficult situations.
- Knows the most effective and efficient process to get things done, with a focus on continuous improvement.
- Basic knowledge of procedure coding and medical terminology.
- Basic knowledge of pharmacy operation especially with claim adjudication.
- In-depth knowledge of brand name, generic name and therapeutic class of medications.
- Basic knowledge of pharmaceutical claims, language, drug usage and generic substitution practices.
- Basic knowledge of Formulary Lists including common edits and restrictions
- Time management and organizational skills. Uses time effectively and efficiently. Values time. Concentrates his/her efforts on the more important priorities. Can attend to a broader range of activities. Meets deadlines.
- Ability to compare and discern the difference between two or more sets of data/information.
- Ability to enter data into and navigate through multiple databases and systems.
- Basic problem solving skills.
- Ability to read, understand and apply oral and written guidelines, instructions and other materials.
- Good oral and written communication skills.
- Interpersonal skills - interacts effectively with individuals both inside and outside of HPSJ; relates openly and comfortably with diverse groups of people.
- Ability to work effectively as part of a team.
- Ability to learn computer medical management systems at a basic level.
- Basic arithmetic skills.
- Good customer service skills.
- Type 45 WPM with 90%.
- 7500 KPH @ 98%.
- Basic skills using Microsoft Word, Excel, and Outlook.
- Ability to speak and be understood in English.
- Ability to treat confidential information with appropriate discretion.
- Basic knowledge of claims processing software and report creation.
- High school diploma or equivalent; and
- At least one year experience working as a Pharmacy Technician.
- Working experience in an outpatient pharmacy or community pharmacy.
- Unrestricted California Pharmacy Technician license.