Pharmacy Technician II Clinical Pharmacy Care Center

Pharmacy Technician II Clinical Pharmacy Care Center

Schedule: 12pm-8:30pm EST

This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

CarelonRx is a proud member of the Elevance Health family of companies. CarelonRx pairs a strong, clinical-first lens with deep pharmacy expertise to create solutions that improve outcomes, control costs, and enhance each member's health.

The Clinical Pharmacy Care Center (CPCC) is a clinical pharmacy call center that services Medicare, Medicaid, and the Commercial member populations. The members we reach out to have been identified as having gaps in care. Our goal is to close those gaps through education and assistance.

The Pharmacy Technician II Clinical Pharmacy Care Center is responsible for the interpretation and data entry of moderately complex prescriptions, prior authorization processing, and troubleshooting adjudication issues.

How You Will Make An Impact:

• Verifies member information and inputs data for the pharmacists.
• Educates members on pharmacy based rules related to prescriptions and medication resources or assistance programs.
• Processes prior authorization requests from physicians offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations.
• Provides resolution to grievances and appeals issues.
• Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits.
• Generates reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports.
• Maintains record keeping of prior authorizations, rebates, and monthly reports.

Minimum Requirements:

• Requires an active, professional license, if required by state law, State Pharmacy Technician Certification or National Certification based on applicable state(s) requirements, to practice as a Pharmacy Technician within the scope of practice in a state or territory of the United States.
• Requires H.S. diploma or equivalent and minimum of 2 years of pharmacy experience; or any combination of education and experience, which would provide an equivalent background.
• For the CPCC business area a current Pharmacy Tech license and certification is required.

Preferred Skills, Capabilities and Experiences:

• Experience communicating with and supporting Medicare members preferred.
• Call center experience with high call volumes preferred.
• Experience in discussing medication adherence preferred.
• Proficient in computer systems and multitasking preferred.
• Patient care experience preferred.

For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the Accessibility Accommodation Request Form and a member of the team will be in contact.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.