Pharmacy Tech II-Bilingual

Pharmacy Tech II-Bilingual

Location: 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.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

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.

Schedule: This role will be working 12:00 pm-8:30 pm EST Monday thru Friday.

The Pharmacy Technician II-Bilingual will be 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 physician's 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.
• 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.

Minimum Requirements:

• Requires an current active, valid unrestricted 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.
• For the CPCC business area a current Pharmacy Tech license and National Certification is required.
• Requires a HS diploma or equivalent and a minimum of 2 years of pharmacy experience; or any combination of education and experience, which would provide an equivalent background.
• Bilingual (Spanish) or multi-language skills required.
• Must be able to pass a validated language test/assessment.

Preferred Skills, Capabilities and Experiences:

• Call center experience preferred.
• PTCB Certification Strongly 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.

Job Level: Non-Management Non-Exempt

Workshift:

Job Family: MED > Licensed/Registered Pharmacist/Pharmacy Technician