About the Company
Elevance Health is a leading health company dedicated to improving lives and communities. We offer a comprehensive suite of health benefits and services, serving millions of members nationwide. Our mission is to transform healthcare through innovation, collaboration, and a commitment to whole-person health. Join our team and be part of a company that is making a real difference in people’s health journeys.
Job Description
As a Managed Care Pharmacy Technician, you will play a crucial role in ensuring the efficient and accurate processing of pharmacy-related claims and member requests within our managed care framework. This office-based position involves direct interaction with internal teams, providers, and members to facilitate prescription approvals, address inquiries, and support various pharmacy benefit management programs. You will be instrumental in helping our members navigate their pharmacy benefits, ensuring they receive the medications they need while adhering to plan guidelines. This role offers excellent benefits and a supportive team environment, contributing directly to our mission of improving health.
Key Responsibilities
- Process pharmacy prior authorization requests and appeals according to established guidelines and regulations.
- Communicate with prescribing providers and members regarding medication coverage, denials, and alternative options.
- Maintain accurate and detailed documentation of all member and provider interactions.
- Assist pharmacists with drug utilization review processes and formulary management tasks.
- Resolve complex pharmacy benefit inquiries and escalate issues as necessary.
- Ensure compliance with all state and federal regulations, as well as internal policies.
- Support the implementation of new pharmacy programs and initiatives.
- Collaborate with interdisciplinary teams to optimize member care and outcomes.
Required Skills
- High School Diploma or GED.
- Active Pharmacy Technician certification (CPhT) through PTCB or NHA.
- Current state pharmacy technician license/registration as required by Indiana law.
- Minimum of 1 year of experience as a Pharmacy Technician, preferably in a managed care, retail, or hospital setting.
- Proficiency in medical terminology and pharmacy calculations.
- Strong communication and interpersonal skills.
- Excellent organizational and problem-solving abilities.
- Ability to work effectively in a fast-paced, office-based environment.
- Proficient with computer systems and data entry.
Preferred Qualifications
- Associate's or Bachelor's degree in a related field.
- Experience with pharmacy benefit management (PBM) systems.
- Familiarity with managed care principles and health plan operations.
- Advanced knowledge of Microsoft Office Suite (Word, Excel, Outlook).
Perks & Benefits
- Comprehensive health, dental, and vision insurance.
- Generous paid time off and holidays.
- 401(k) retirement plan with company match.
- Life and and disability insurance.
- Tuition reimbursement and professional development opportunities.
- Employee wellness programs.
- Flexible spending accounts (FSA) and health savings accounts (HSA).
- Employee assistance program.
How to Apply
If you are interested in this position, please click the "Apply Now" button below. To ensure your application is properly considered, please prepare the following:
- An up-to-date Resume or CV
- A brief cover letter summarizing your experience and motivation
Applications are reviewed on a rolling basis. Only shortlisted candidates will be contacted for an interview.
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