UM Pharmacy Technician
NAMM North America Medical Management - Ontario, CA

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The Pharmacy Technician will be responsible for managing all requests for injectable/infusion medications requested by physicians in a timely manner. This position will confirm eligibility, benefits, channel services based on senior or commercial member guidelines, and obtain a correctly completed prescription to facilitate medication dispensing from one of our contracted specialty pharmacy vendors.

Manage incoming requests for specialty medications

Confirm benefits, eligibility, co-payments, and coinsurance

Data entry of request for specialty medication/visit requests into the prior authorization system

Management of turn around times for authorization based on established standards

Works in collaboration with the Licensed Nurse to obtain all necessary clinical information to apply the authorization guidelines

Staying current on health plan formulary updates

Assists with Grievance and Appeals Department by providing necessary documentation for upholding decision

Licensed Pharmacy Technician (preferred)
Minimum 2 years experience as a Licensed Pharmacy Technician working in a retail pharmacy / pharmacy benefit management company or similar duties as a UM Technician working in a Managed Care environment. Must be familiar with UM processes and HMO management

NAMM North America Medical Management - 16 months ago - save job - block