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Pharmacy Technician III

Company: Health Net, Inc.
Location: Fresno
Posted on: September 13, 2019

Job Description:

Description: Position Purpose: Track and triage all coverage determination requests for prior authorizations and Medicare Part D recipients. * Support Medicaid prior authorization requests by approving coverage determination requests based on defined criteria Document prior authorization determination requests into the PBM system and notify providers and/or members * Track and triage all prior authorization requests for Medicaid and coverage determination requests for Medicare D Recipients and determine if a pharmacist review is required * Obtain verbal authorizations and request detailed clinical information from prescribers * Assist with complex coverage approvals and determination requests based on defined criteria * Enter and document coverage determination request decision into pharmacy system and notify providers and/or members * Respond to client inquiries regarding authorization approvals and PBM online applications * Refer coverage determination requests for specialty drugs to delegated vendor or client for processing * Contact providers for additional information to facilitate coverage determination reviews * Assist management in delivering training material to pharmacy technicians * Work weekend or alternative shifts as needed

Keywords: Health Net, Inc., Fresno , Pharmacy Technician III, Professions , Fresno, California

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