See all roles

Pharmacy Tech UM Remote - PST Hours -State & Ntl Cert

Work from home Full-time role Hiring

Molina Healthcare is hiring for a Pharmacy Technician who is BOTH State Licensed/Certified and Nationally certified. This role is 100% remote, and the hours will be Mon-Fri 11am to 730pm Central Standard Time. • This role will be working in the UM Pharmacy reviewing incoming Prior Auth requests for Medicaid and Marketplace members through both the medical and pharmacy benefit. There will be coordination with pharmacists to make determinations on cases. Highly qualified candidates for this role will have the following experience- • Positive "Can Do" attitude • Specialty Pharmacy (any) and Retail Pharmacy (at least 3 years) experience are ideal • Must be computer savvy- able to work within several computer systems at once, MS Note experience a plus • Managed care experience • High level of communication skills, both written and verbal • Able to utilize resources to work independently Molina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal and state laws. Jobs in this family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services (such as, therapeutic drug monitoring, drug regimen review, patient education, and medical staff interaction), and oversight (establishing and measuring performance metrics regarding patient outcomes, medications safety and medication use policies). 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 Apply Job!

You might like

VFX Animator (Non-Remote)

Work from home Full-time role

Virtual Apron Senior Flooring Sales Specialist - Remote

Work from home Full-time role

South Airlines Call Center Rep Work From Home Jobs – Job Vacancy

Work from home Full-time role

Set Up Attendant

Work from home Full-time role

Delivery Excellence Manager

Work from home Full-time role

Seasonal Call Center Area Manager

Work from home Full-time role

Cloud Architect (need resumes by 1/28)

Work from home Full-time role

RMC Customer Service Representative

Work from home Full-time role

Entry Level Insurance Billing (remote)

Work from home Full-time role

AI Specialist - Pharmaceutical & Healthcare AI Applications

Work from home Full-time role

Global Head of Research Compliance

Work from home Full-time role

Innovation Investigator Associate – Data Entry, Business Analysis & Technology Support (Part-Time) – Join arenaflex's Innovation Team

Work from home Full-time role

Experienced Data Entry Clerk – Entry-Level Opportunity with arenaflex

Work from home Full-time role

Senior Analyst - Cyber Intelligence (Remote)

Work from home Full-time role

Experienced Data Engineer – Operations Analytics (OA) Team – Work From Home

Work from home Full-time role

Experienced Full Stack Data Entry Specialist – Live Chat, Remote Work Opportunity at arenaflex

Work from home Full-time role

YouTube Jobs (Content Moderator) $26/Hour

Work from home Full-time role

Legal Consultant

Work from home Full-time role

Senior Specific Claim Auditor

Work from home Full-time role

Software Engineer, LLM - USDS

Work from home Full-time role