Clinical Pharmacy Technician II
Job DescriptionThere are two positions open. Both positions have a strong need for bilingual candidates.
One position is in Cambridge, MA and the hours are 12:00 p.m. - 8:00 p.m.
One position is in Phoenix, AZ and the hours are 9:00 a.m. - 5:00 p.m.
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.
General Job Information
TitleClinical Pharmacy Technician II
Job FamilyPharmacy Group
CountryUnited States of America
FLSA StatusUnited States of America (Exempt)
Recruiting Start Date1/7/2019
Date Requisition Created1/7/2019
EducationGED (Required), High School (Required)
License and Certifications - RequiredRPH - Registered Pharmacist - Pharmacy
License and Certifications - PreferredPharmD - Doctor Of Pharmacy, State Licensure - Pharmacy
Other Job Requirements
- CPT: Certification/licensure in accordance with state requirements. In the states of Florida and Michigan, license registration with the Board of Pharmacy is required without exception.
- PTCB: Certification or the ability to obtain PTCB Certification within one year of hire. Employees in states which require a Pharmacy Technician certification/registration exam may substitute state certification/registration for the PTCB.
- 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 6 months dispensing or retail experience required, or equivalent internal training will be substituted.
- Ability to identify and trouble-shoot problematic issues.
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.
Top 5 reasons to work at Magellan
Meaningful Work With People Who Care
At Magellan Health you can do meaningful work and feel confident that you matter in an organization that makes a real difference in the world - one that cares deeply and uses its employees’ collective insight as a competitive advantage.Read More
We are Compassionately Curious
Magellan Health is a place where we listen with real empathy. It’s one of our biggest strengths. It helps us to support each other and develop innovative solutions for the fastest growing, most complex areas of healthcare.Read More
We are Better Together
We rely on our innate ability to work as a high-functioning collaborative team to facilitate compassionate care to all of our members. With such interdependency comes trust, challenge and innovation.Read More
We believe work and life should flow together in unison. We offer resources that match your professional development, a culture that welcomes your ideas, and unparalleled flexibility to fit work around your life.Read More
Be your best at Magellan Health. We’re a collective of remarkably motivated and driven professionals. As a team, we’re proud of the high standards we set for each other and we’re continually inspired to do our best work.Read More
When you sayLife @ Magellan
To be the best you have to work with the bestWe hear you