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Clinical Pharmacy Technician II

Company: Magellan Health
Location: Albany
Posted on: May 22, 2020

Job Description:

Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.


  • Determines appropriateness for medications. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists. Researches, resolves and documents prior authorization outcomes in pharmacy system.
  • Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician`s office staff, medical management staff and/or pharmacists.
  • Escalates requests to Pharmacist when request requires extensive clinical review or denial.
  • Monitors telephone system to ensure adequate staffing to maintain client services levels.
  • Assesses training needs within the team. Serves as a training resource, mentor and coach to others. Identifies and shares best practices.
  • Demonstrates, advocates and reinforces a positive team environment.
  • Other duties as assigned.

    General Job Information

    TitleClinical Pharmacy Technician IIGrade18Job FamilyPharmacy GroupCountryUnited States of AmericaFLSA StatusUnited States of America (Non-Exempt)Recruiting Start Date4/16/2020Date Requisition Created4/16/2020Work ExperiencePharmacyEducationGED (Required), High School (Required)License and Certifications - RequiredCPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - PharmacyLicense and Certifications - Preferred

    Other Job Requirements

    Responsibilities

    • CPT: Certification/licensure in accordance with state requirements. In the states of Florida, Rhode Island and Michigan, license registration with the Board of Pharmacy is required without exception.
    • National Certification such as PTCB or ExCPT: Certification or the ability to obtain certification within one year of hire. Employees in states which require a Pharmacy Technician certification/registration exam may substitute state certification/registration for the national certification.
    • Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.
    • In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).
    • Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.
    • Excellent written and verbal communication skills.
    • Ability to follow clinical criteria and instructions to approve prior authorization requests.
    • Minimum of 2 years dispensing or retail experience required, or equivalent internal training will be substituted.
    • Ability to identify and trouble-shoot problematic issues.

      Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.

Keywords: Magellan Health, Albany , Clinical Pharmacy Technician II, Healthcare , Albany, New York

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