What are the responsibilities and job description for the Pharmacy Technician (Medicaid/Marketplace) Remote - PST Hours position at Molina Healthcare Group?
Job Description
Molina Healthcare is hiring for a Pharmacy Technician who is State Licensed/Certified and/or PTCB certified.
This role is 100% remote, and the hours will be Mon-Fri 10am to 630pm Pacific Standard Time.
This role will be reviewing prior authorization requests for medications to be reviewed by the RPh’s and or MD’s for determination, assisting in determining medical necessity for medications along with assisting with pharmacy claims.
Highly qualified candidates for this role will have the following experience-
- 2 years in a retail setting
- Prior Authorization experience
- Must be computer savvy- able to work within several computer systems at once
- Managed care experience
- High level of communication skills, both written and verbal
KNOWLEDGE/SKILLS/ABILITIES
- Performs initial receipt and review of non-formulary or prior authorization requests against plan approved criteria. Requests additional information from providers as needed to properly evaluate the request.
- Accurately enters on-line approvals or denials of requests. Authorized to make and carry out simple prior authorization requests within established policies and procedures.
- Participates in the development /administration of programs designed to enhance the utilization of targeted drugs and the identification of cost saving pharmacy practices.
- Identifies and reports departmental operational issues and resource needs to appropriate management.
- Assists Molina Member Services, pharmacies, and health plan providers in resolving member prescription claim, prior authorization, or pharmacy services access issues.
- Articulates Pharmacy Management policies and procedures to pharmacy/health plan providers, other Molina staff and others as needed.
JOB QUALIFICATIONS
Required Education: High School Diploma or GED equivalent
Preferred Education: Associate degree
Required Experience: 2 years’ experience as a Pharmacy Technician
Preferred Experience: 3 years
Required License, Certification, Association: Active and unrestricted Pharmacy Technician Certification
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Key Words: Pharmacy Technician, Pharm Tech, Tech, National Certification, State License, Certification, Claims, Pharmacy Claims, Pharmacy, PBM, National Certified Pharmacy Technician (CPhT) certification, Medicaid, Medicare, Managed Care, MCO, Exchange, PBM, Pharmacy Benefit Management, Prior Auth
Same Posting Description for Internal and External Candidates
Job Info
Job Identification: 2029282
Job Category: Pharmacy
Posting Date: 2025-01-11T15:55:19 00:00
Job Schedule:
