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Centene Corporation Pharmacy Technician III in Fairport, New York

HourlyPosition Purpose: Track and triage all coverage determination requests for prior authorizations and Medicare Part D recipients.

  • Support Medicaid prior authorization requests by approving coverage determination requests based on defined criteria Document prior authorization determination requests into the PBM system and notify providers and/or members

  • Track and triage all prior authorization requests for Medicaid and coverage determination requests for Medicare D Recipients and determine if a pharmacist review is required

  • Obtain verbal authorizations and request detailed clinical information from prescribers

  • Assist with complex coverage approvals and determination requests based on defined criteria

  • Enter and document coverage determination request decision into pharmacy system and notify providers and/or members

  • Respond to client inquiries regarding authorization approvals and PBM online applications

  • Refer coverage determination requests for specialty drugs to delegated vendor or client for processing

  • Contact providers for additional information to facilitate coverage determination reviews

  • Assist management in delivering training material to pharmacy technicians

  • Work weekend or alternative shifts as needed

Education/Experience: High school diploma or equivalent. 3+ years of retail, hospital or mail order pharmacy experience. Working knowledge of Microsoft Suite and pharmacy systems.

License/Certification: Current state’s Pharmacy Technician license and National Certification.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

TITLE: Pharmacy Technician III

LOCATION: Fairport, New York

REQNUMBER: 1137710

COMPANY: Health Insurance Operations