Pharmacy Technician, Intermediate

Job Description

Your Role

The UMRx Prior Authorization Technician team is primarily responsible for ensuring accurate and timely review of IV and injectable medications under the medical benefit, using Blue Shield of California Pharmacy and Therapeutics (P&T) Committee medication polices. The Pharmacy Technician, Intermediate, will report to the Operations Supervisor. In this role you will provide support for staff pharmacists using operational expertise to prepare medication cases for clinical review outside of technician EOA. Ensure compliance with various regulatory and quality accreditation requirements around drug utilization management.

Responsibilities

Your Work

In this role, you will :

• Utilize medication policy and operational principles to make authorization determination on drug case reviews within technician extension of authority.
• Research and collect pertinent patient and drug information to assist the pharmacists in case specific reviews and drug evaluations.
• Ensure coverage determinations are completed within regulatory turnaround times for all lines of business.
• Work in team environment to manage technician queues.
• Ability to maintain individual work queue.
• Communicates with the physicians, physician's office staff, and pharmacies to assist with case resolution.
• Ability to communicate well with other team members and help to create team synergies.
• Participates in, evaluates and maintains efficient workflow procedures.
• Additional activities as assigned and discussed with manager, including participation in all workstreams within UMRx, including but not limited to, intake, system testing, Peer to Peer.
• Work weekend and holiday rotation schedule.
• Perform other duties as assigned by the Management Team.

Qualifications

Your Knowledge and Experience

Your Pay

The pay range for this role is : $ 20.70 to $ 28.98 for California.

Note

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

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About the Team

Blue Shield of California's mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our continued commitment to diversity, equity, and inclusion upholds our values and advances our goal of creating a healthcare system that is worthy of our family and friends while addressing health disparities, promoting social justice, and integrating health equity through our products, business practices, and presence as a corporate citizen.

Blue Shield has received awards and recognition for being a certified Fortune 100 Best Companies to Work, Military Friendly Employer, People Companies that Care, a Leading Disability Employer, and one of California's top companies in volunteering and giving. Here at Blue Shield, we strive to make a positive change across our industry and communities - join us!

Our Values :

Our Workplace Model :

At Blue Shield of California, we believe in fostering a workplace environment that balances purposeful in-person collaboration with flexibility. As we continue to evolve our workplace model, our focus remains on creating spaces where our people can connect with purpose - whether working in the office or through a hybrid approach - by providing clear expectations while respecting the diverse needs of our workforce.

Two Ways of Working :

Member-facing and approved out-of-state roles remain remote.

Physical Requirements :

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office / deskwork - Activity level : Sedentary, frequency most of work day.

Please click here for further physical requirement detail.

Equal Employment Opportunity :

External hires must pass a background check / drug screen. Qualified applicants with arrest records and / or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws. Learn More

Salary : $21 - $29