Clinical Pharmacy Tech II - Pharmacy Prior Authorizations

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Responsible for securing patient data based upon comprehensive data elements, financial education/counseling, insurance verification, provision of clinical information for pre-certification, authorization and third party claims management. Interviews patient for clinical, financial, and history information and arranges appropriate clinical care. A Clinical Pharmacy Technician will work independently gathering and submitted patient information with oversight of a pharmacist as needed. They will be responsible for performing pharmacy related functions in compliance with departmental policies and procedures that provide optimal pharmaceutical care.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:

1. High school diploma or Equivalent.


2. Must possess current licensure as required by state board where services will be provided:


MD: Pharmacy Technician Student Permit or Pharmacy Technician License through Maryland Board of Pharmacy


OH: Pharmacy Technician Trainee License or Certified or Registered Pharmacy Technician License through Ohio Board of Pharmacy


PA: Pharmacy Technician Trainee or Pharmacy Technician License through the Pennsylvania Board of Pharmacy


WV: Pharmacy Technician Trainee or Pharmacy Technician License through West Virginia Board of Pharmacy


Remote Workers Only: Must additionally hold Pharmacy Technician Trainee License or Pharmacy Technician License issued by state of residence.

3.Nationally Certified Pharmacy Technician through Pharmacy Technician Certification Board (PTCB) or National Healthcareer Association (NHA) OR If applicant has two (2) or more years of pharmacy specific experience, must be obtained within 15 months of hire.


PREFERRED QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:


1. Associates degree OR Post high school education in a science field of study OR graduate of a pharmacy technician training program.


2. Nationally Certified Pharmacy Technician through Pharmacy Technician Certification Board (PTCB) or National Healthcareer Association (NHA) upon hire.


CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned.

1. Drafts various correspondence letters and sends to referral source when necessary.

2. Gathers and documents patient demographics, insurance information, needs assessment, patient history, and other data as needed.

3. Initiates refill/follow up calls and schedules delivery as needed

4. Provides information and answers to patient/caregiver questions and refers to clinician when appropriate or requested.

5. Identifies all patients requiring pre-certification or pre-authorization at the time services are requested or when notified by another hospital or clinic department.

6. Contacts insurance company or employer to determine eligibility and benefits for requested services.

7. Maintains patient records in a timely and complete manner.

8. Assists the pharmacist with the process of filling and labeling the prescriptions.

9. Calculates initial measurements for compounds and maintains compounds logs.

10. Provides monographs and other required medication guides with each prescription.

11. Maintains proper storage of medications (i.e. security, temperature controlled items, etc.).

12. Demonstrates the knowledge and skills necessary to communicate to the infant, pediatric, adolescent, adult and/or geriatric patient per the established age-specific education/standard.

13. Works with coordinators and manager to develop and attain quarterly objectives.

14. Maintains confidentiality according to policy when interacting with patients, physicians, families, co-workers and the public regarding demographic/clinical/financial information.

15. Communicates problems hindering workflow to management in a timely manner.

16. Assists in the training of pharmacy technicians

17. Initiates charge anticipation calculations. Accurately identifies anticipated charges to assure identification of anticipated self-pay portions.

18. Certain duties cannot be assigned to Pharmacy Technicians because these duties can only be performed by pharmacists. These restrictions are regulated at state and federal levels and must be followed closely:

• Only pharmacists can receive oral prescriptions from prescribers or prescribers' authorized designees. (This refers primarily to new telephone prescriptions).

• Only pharmacists can consult with prescribers or prescribers' designees about patients' prescriptions.

• Only pharmacists can provide confidential patient information to other health professionals or insurance companies.

• Only pharmacists can check medications before dispensing them to patients. (In states where technicians can prepare or package prescriptions, they do so under the direct supervision of a pharmacist.)

• Only pharmacists can consult with patients about prescribed medication use and other health issues.

• Only pharmacist scan recommend over-the-counter medications.


PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. While performing the duties of this position, the employee is required to walk and stand or sit for long periods of time.


2. Must be able to lift 30 pounds and must be able to push 50 pounds.

3. Dexterity required to finger, handle, and reach.


WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

SKILLS AND ABILITIES:

1. Must be able to use computers and software applications.

2. Knowledge of drugs, drugs dosing, side effects, indications, contraindications and proper administration preferred.

3. Knowledge of rules, policies and regulations related to the disbursal of pharmaceutical drugs preferred.

4. Must be able to work accurately, efficiently, and safely in a fast-paced environment.

5. Must be polite and respectful when communicating with staff, physicians, patients and families. Must approach interpersonal relations in a positive manner.

6. Must demonstrate flexibility to meet the needs of department or hospital in regard to changes in work volume, planned change, scheduling changes and emergency call-backs (i.e. weather or disaster).

7. Must be able to communicate effectively verbally and in writing and place high emphasis on customer service.


Additional Job Description:

Scheduled Weekly Hours:
40

Shift:
Day (United States of America)

Exempt/Non-Exempt:
United States of America (Non-Exempt)

Company:
WVUH West Virginia University Hospitals

Cost Center:
233 WVUH Specialty Pharmacy

Address:
3040 University Ave

Morgantown

West Virginia

Equal Opportunity Employer

West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.