Pharmacy Technician
Description
Reviews and processes formulary change requests from Health Net plans. Submits and maintains formulary change requests to Health Net's pharmacy claims processor. Generates, maintains and reviews Formulary Status Grids. Uses reports to perform audits and quality checks on the current formulary status for accuracy and contract compliance. Assists Clinical Pharmacist with formulary database maintenance and updates to company web site.
Pharmacy Audit And Recovery
Performs a variety of assignments required for pharmacy audit and recovery functions. Reviews paid claims for quantity and/or billing discrepancies. Corresponds with pharmacies as needed to communicate review findings. Faxes inquiries to pharmacies related to review findings. Answers in-coming calls and responds appropriately to faxed correspondence from pharmacies. Updates Access database with incoming phone calls, faxes and e-mails. Performs other duties as assigned. Complies with all policies and standards.
Responsibilities
The Pharmacy Technician may perform duties in one or more of the following areas: Formulary Management, Pharmacy Audit and Recovery, Pharmacy Service Center, Medicare Part D/Part B, Appeals, Medicare Part D Operations and State Health Programs Pharmacy Operations or Prior Authorization. Using established company guidelines, the Pharmacy Technician reviews requests made by physicians, medical groups, pharmacies and members for the use of prescription drugs and pharmacy benefits. The technician researches and resolves questions, problems or issues. May consult with Clinical Pharmacists or Regional Medical Director on related issues.
Qualifications
- High School diploma or GED required
- 1 year Pharmacy Technician experience
- Customer Service/retail experience preferred
- Valid Pharmacy Technician License preferred
Pay
$19.43 - $32.98 per hour
Benefits
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.