Senior Pharmacy Technician (Valid Certification Required)Primary Location: Houston, TX
Additional Locations: TX-Houston Apply
- High volume call center and production unit.
- Evaluates and authorizes approval of pharmacy requests received by telephone, facsimile, and/or other means using client clinical criteria. Determines appropriateness for medications. Communicates decision to physicians, physician’s office staff, medical management staff, members, and/or pharmacists.
- May perform clinical research to support request
- Utilizes various proprietary systems to build, research, process and enter requests.
- Performs non-medical research including eligibility verification, COB, and benefits verification.
- Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
- Escalates requests to Pharmacist when request requires extensive clinical review or denial.
- Promotes communication, both internally and externally, to enhance effectiveness of medication therapy management services.
- Protects the confidentiality of member information and adheres to company policies regarding confidentiality
- May communicate with Aetna Case Managers and Health Plan staff
- Process requests in compliance with various laws and CMS regulations and company policies and procedures.
- Sedentary work involving significant periods of sitting, talking, hearing, and keying.
- Work requires visual acuity to perform close inspection of written and computer-generated documents as well as dual PC monitors.
- Experience in retail, hospital, facility or call center is preferred.
- Proficiency in computerized pharmacy systems and software applications.
- Excellent verbal and written communication skills.
- Experience with Windows-based software applications.
- High School Diploma or G.E.D.
- National Pharmacy Technician certification and Texas State License, current and in good standing, are required.
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