5 Positions - Remote Roles - The candidates should be in MI

Job Responsibilities:

• Support providers (pharmacists and physicians) with Medicare Part D drug coverage inquiries, Grievances, and prior authorizations.
• Answer telephones in an efficient and timely manner to lend appropriate assistance to providers
• Process prior authorization requests under the supervision of a Clinical Pharmacist.-
• Apply pharmacy prior authorization criteria used in the adjudication of pharmacy PA requests.
• Analyzing written, faxed, and verbal inquiries which leads to entry of pharmacy authorizations into the system.
• Communicate coverage determination status to physicians and/or members and effectuate such decisions within the authorization tool.
• Troubleshoot problems, inquiries, and new processing procedures for coverage determinations.
• Perform other related duties as assigned.

Employment Qualifications:

• Associates degree required. Bachelors preferred
• Active unrestricted Pharmacy Technician License or Pharmacy Technician Certification (PTCB) required.
• At least two (2) years experience in retail or hospital pharmacy preferred
• Knowledge of prescription drug names and therapeutic classes
• Experience with Medicare Part D prescription benefits is preferred