At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us.

Job Posting Title

Clinical Pharmacy Technician Sr - Remote

Job Description

Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.

Responsibilities

• 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.

Minimum Qualifications

• Education Level
  • GED
  • High School

• Required CPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy
• 2+ years Pharmacy

Must be eligible to work in the United States without the need for work visa or residency sponsorship

Additional Qualifications

• Must have an active pharmacy technician licensure or registration in accordance with state requirements.
• If state does not require an exam for licensure/registration, must possess both active pharmacy technician licensure or registration in accordance with state requirements AND an active national certification (e.g., PTCB or ExCPT).
• In states that do not require licensure or registration, must have an active national certification (e.g., PTCB or ExCPT).
• 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.

Preferred Qualifications

Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures

Every employee must be able to perform the essential functions of the job and, if requested, reasonable accommodations will be made to enable employees with disabilities to perform the essential functions, absent undue hardship. In addition, Prime retains the right to change or assign other duties to this job.

Potential pay for this position ranges from $19.23 - $28.85 based on experience and skills.

To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page and click on the "Benefits at a glance" button for more detail (https://www.primetherapeutics.com/benefits).

Prime Therapeutics LLC is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sex (including pregnancy), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law.  

We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.

Prime Therapeutics LLC is a Tobacco-Free Workplace employer.

Positions will be posted for a minimum of five consecutive workdays.