Prospect Medical is searching for a qualified:|
The main responsibilities of the pharmacy technician include 1) providing assistance in reviewing pharmacy vendors’ compliance with contracts; 2) providing support for implementing pharmacy initiatives & processes; and 3) conducting initial reviews for pharmacy referrals before a pharmacist’s review.
ESSENTIAL DUTIES AND RESPONSIBILITIES
The following are included but not limited to:
- Handle daily pharmacy referrals : 1) Process pharmacy referrals by ensuring required clinical information has been provided by physician offices, the request meets health plan guidelines (for certain medications), and the patient’s eligibility is verified; 2) Prepare monthly pharmacy referral statistics.
- Provide support for internal monitoring processes for specialty pharmacy expenditure : 1) Review paid drug claims data based on the medical group’s current DOFR (Division of Financial Responsibilities) arrangements with various health plans and approved pharmacy referrals. 2) Prepare quarterly pharmacy claims reports for Ventegra’s rebate program; 3) Generate a monthly new drug report for new chemical entities to identify targeted new drug reviews and UM strategies required for high cost drugs; 4) Provide assistance in reviewing specialty pharmacies’ pricing (e.g., GPO) based on current contracts.
- Provide support for pharmacy initiatives : 1) Generate monthly and quarterly generic medication reports for distribution by mail or email to targeted physician groups; 2) Assist the Clinical Pharmacist in implementing new or revised pharmacy reports; 3) Coordinate preparations for meetings with external customers and committee members needed for pharmacy programs or operations.
The applicable candidate must hold an active pharmacy technician license in the state of California. Managed care experience (e.g., health plans, pharmacy benefit management companies, medical groups) is preferred. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. This job description reflects management's assignment of essential functions, it does not prescribe or restrict the tasks that may be assigned. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Microsoft Word, EXCEL & PowerPoint
Understanding of drug packaging & pricing (e.g., AWP, ASP)
Prospect Medical has a solid past and a dynamic future. Over 20 years old, we have grown and matured---we are now a publicly-traded IPA and medical management services company. We contract with all major regional HMO’s including PacifiCare, Blue Cross, Health Net and CIGNA. We are now serving California’s seniors with a superior Medicare program, and we are pursuing additional growth through a strategy of targeted acquisition. We succeed through the use of superior technology, proven management procedures, and committed employees. Our success allows us to offer excellent compensation and one of the best benefit packages in the industry.
If you are a qualified , high-achieving professional who wants to make a positive difference in the world of managed care, please submit your resume online.
Quality Service, Quality Care…that’s who we are!
Please visit our website for more information and a listing of all our open positions
Monster - 13 months ago