Job Description

• Schedule: Monday to Friday, 8:30 am to 5 pm. Saturday availability based on business needs.
• Position Type: On-site
• Job Purpose: Responsible for the interpretation and data entry of basic prescriptions, prior authorization processing, and troubleshooting adjudication issues.
• This is a member-facing position, so flu and COVID vaccinations are required.

Primary Duties:

• Verify member information and input data for the pharmacists.
• Educate members on pharmacy-based rules related to prescriptions and medication resources or assistance programs.
• Process prior authorization requests from physicians' offices and ensure compliance with Medicare requirements; inform relevant parties of all prior authorization determinations.
• Provide resolution to grievances and appeals issues.
• Respond to inquiries from physicians, sales team, and members related to formulary and prescription benefits.
• Generate reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports.
• Maintain record-keeping of prior authorizations, rebates, and monthly reports.
• Assist the Pharmacist in reviewing, processing, preparing, filling, labeling, and dispensing medications and supplies.
• Arrange work activities to meet the pharmaceutical needs of customers.
• Answer phones, respond to questions and requests, or refer them to appropriate staff for medication information.
• Maintain records by recording and filling physician’s orders and prescriptions.
• Complete data entry department-related functions, request, and process prior authorizations.
• Maintain a clean and safe pharmacy by complying with procedures, rules, and regulations.
• Communicate effectively with other professionals and support staff to achieve positive customer outcomes.
• Promote and contribute to a positive, problem-solving environment.
• Assist customers, family members, and others with concern and empathy; respect their confidentiality and privacy and communicate with them in a courteous and respectful manner.
• Comply with company policies and procedures and maintain confidentiality of customer medical records in accordance with state and federal laws.
• Ensure compliance with all HIPAA, OSHA, and other federal, state, and local regulations.
• Participate in meetings, training, and in-service education, as required.
• Perform other duties as assigned.

Skills and Qualifications:

• Minimum of a high school diploma or equivalent.
• Valid Registered Pharmacy Technician License in Florida is required.
• Pharmacy Technician Certification Board certificate preferred.
• Minimum one year of experience as a Registered Pharmacy Technician, experience in a retail pharmacy setting preferred.
• Previous experience in a pharmacy environment and familiarity with pharmacy terminology.
• Excellent computer knowledge, including proficiency in Microsoft Office.
• Fluency in Spanish and English is preferred.
• Call center skills required; customer relations experience helpful.
• Must be patient in dealing with an elderly population and sympathetic to hearing or vision deficiencies.
• Excellent listening, interpersonal, verbal, and written communication skills with individuals at all levels of the organization.
• Ability to work effectively independently and in a team environment.
• Must be self-motivated, organized, and have excellent prioritization skills.
• Must be able to work well under stressful conditions and in a fast-paced environment.

Additional Information:

• This is a member-facing position, so flu and COVID vaccinations are required.
• The role involves a hybrid environment between call center tasks and pharmacy fulfillment tasks.
• Two weeks of training will be provided from 8:30 am to 5 pm.
• Possibility of working on Saturdays depending on workflow.
• This is a cleanup effort, so it will not likely convert to a full-time position, but it could be extended if the work is not completed.

Interview Process:

• Two interviews: one phone and one on-site.
• On-site interviews will introduce the workflow, discuss the uniform and details of the first day, and assess where the candidate needs to start training.

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