Clinical Pharmacy Technician I
IntegratedResourcesINC
Posted: February 16, 2017
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Quick Summary
Evaluates and authorizes prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.
Required Skills
Job Description
Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.
· 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.
· Researches, resolves and documents physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management.
· performs other duties as required.
Qualifications
· Minimum of 6 months dispensing or retail experience required, or equivalent internal training will be substituted.
· CPT - Certification/licensure in accordance with state requirements.
· PTCB National certification required.
· 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.
· Ability to identify and trouble-shoot problematic issues.
Schedules- SCHEDULE FOR THE FIRST 4 WEEKS OF TRAINING WILL BE: 9AM-530PM.
SCHEDULES AFTER TRAINING - ALL POSSIBLE SHIFTS:
5ppl - Monday - Friday; 9am-530pm (30 min lunch)
3ppl- Tuesday- Saturday 12pm-8:30pm (30 min Lunch)
Feel free to forward my email to your friends/colleagues who might be available. We do offer referral Bonus.
Thank you.
Kind Regards,
Harris Kaushik
Clinical Recruiter
Integrated Resources, Inc.
IT Life Sciences Allied Healthcare CRO
DIRECT # - (732)-844-8715
Gold Seal JCAHO Certified ™ for Health Care Staffing
“INC 5000’s FASTEST GROWING, PRIVATELY HELD COMPANIES” (8th Year in a Row)