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Pharmacy Services Associate-25448-1 MPK
Monterey Park, California | Contract
EXCITING 6 MONTH CONTRACT FOR EXPERIENCED PHARMACY SERVICES ASSOCIATE IN MONTEREY PARK!
Day to Day Responsibilities of this Position and Description of Project:
Pharmacy Services Operations Associate
Provides efficient and accurate responses to external customers (physicians, office staff, pharmacy providers, members and brokers) and internal team members. Resolves outpatient pharmacy benefit coverage (inclusion/exclusion), prescription claim problems, communicates drug formulary guidelines including drug formulary alternatives, prior authorization criteria and group/member eligibility problems. Researches and solves administrative review and consumer affairs issues.
• Under general supervision, coordinates, assists in and supports implementation of procedures and guidelines for the drug prior authorization program for the outpatient Pharmacy Benefit.
• Communicates with the physician, physician’ s office staff, medical management and other team members to assist with accurate and efficient resolution of prior authorization requests
• Assists in providing formulary alternatives and communicates prior authorization criteria, and discusses pharmacy benefit coverage inclusions/exclusions when required
• Interfaces in a courteous and professional manner with physicians, physician office staff, contracted pharmacists, patients, and other team members during the prior authorization process
• Provides drug usage history and other pertinent pharmacy benefit related computer searches for pharmacists and Medical Director to assist in case specific reviews and drug evaluations.
• Assists pharmacists with drug utilization review programs, NCQA QI programs or other assigned projects
• Communicates prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physician, physician office staff, medical management staff, sales, member/customer services
• Assists in research and resolution of physician inquiries and grievances
• Provides essential clinical information to Member Services, Administrative Review Department and Consumer Affairs to resolve Member inquires and grievances
Education and Experience:
Currently in training or recently completed training but has not consistently reached production/quality standards
Identifies issues and with assistance executes corrective action
In process of developing specific skills needed to perform non-routine tasks
Generally requires minimal (0-2 years) pharmacy related experience
At least 2 years of Pharmacy experience
Good verbal and written communication
Typing: 40 wpm min
Must be customer service oriented
Current California Pharmacy Tech License, National Pharmacy Technician license preferred