Pharmacy Technician - 100% Fully REMOTE - Join a Market Leader

Job Summary:

We’re a fully licensed health insurer. Our goal is to make healthcare simple, transparent, and human.

We are changing how health insurance works by creating a healthcare experience that’s intuitive and puts people, not cost or workflows, first. We’re using a consumer-focused and tech-driven approach to do so. This positions us uniquely in the space - and creates one of the biggest opportunities in healthcare.

We brought together leaders from top technology, service and healthcare companies to deliver on our promise and seize this opportunity. We all work side by side in a collaborative, energetic, and creative environment. The result: better people, better ideas, and better healthcare.

In this role, you will play an essential role in building our pharmacy utilization management function. The Clinical Review team is one of most important clinical functions - we encourage evidence-based practice through utilization review to ensure our members get access to the right care - particularly those who need it most. You will be responsible for understanding and helping to grow our pharmacy utilization management program and driving high quality reviews.

Skills:

As a Pharmacy Technician/Pharmacy Processor, dedicated to high quality pharmacy decision-making and improving the member and provider experience, you’ll be responsible for:

• Determining eligibility and screening incoming pharmacy prior authorization requests for all required documents

• Preparing, organizing,and distributing pharmacy prior authorization requests for review by pharmacist/physician and responding to pharmacist/physician requests for additional information

• Learning and using vendor tools to create, process, and properly track pharmacy prior authorization requests

• Collecting relevant medical information (via telephone, fax, and portal) and applying the appropriate PA criteria

• Meeting required decision-making timeframes, including promptly triggering escalation for cases requiring pharmacist review

• Clearly documenting all communication and decision-making, ensuring a peer could easily reference and understand your decision

• Communicating oral and written prior authorization outcome notifications that comply with standards and requirements for timeliness, content and accuracy

• Demonstrating the highest level of professionalism, accountability, and service in your interactions with teammates, customer service, providers, and members

• Participating in quality improvement activities as requested

• Developing a working familiarity with applicable regulatory and accreditation requirements

• Providing support on regulatory audits and quality accreditation surveys, as needed

• Supporting the team prepare for expansion into new markets, as needed

About Medix?

Medix is dedicated to positively impacting lives every day. Since 2001, we have made it our mission to be the leading provider of workforce solutions for clients and candidates across the Healthcare, Scientific, and Information Technology industries.

Our dedicated recruiters are here to help you find and secure just the right opportunity. We take the time to learn about you, your skills, your interests, and your career goals, and then match you with the jobs and companies that best suit your needs. Whether you are looking for a contract, contract-to-hire, or direct hire positions, we can help you to find the meaningful and gratifying work that you've been looking for. Let Medix be your partner as you move your career forward. Contact us today!

Benefits

Once you have been a contract employee of Medix for 30 days, you become eligible for our Benefits Program. Should you elect to enroll, there are three levels of medical coverage to choose from, supplemental dental plans and term plans as well as the option to enroll your spouse and/or children. You can select the best combination that best suits your needs.

As a contract employee with Medix, you can choose to enroll in our Benefits Program during your eligibility period and enjoy:

• Minimum Essential Coverage (MEC) plan

• Two different fixed indemnity plan add-ons

• Major Medical Plans, including 1 HSA Plan

• Dental

• Vision

• Short-term disability

• Life and AD&D

This year’s recipient of the Business Ledger's "Entrepreneurial Excellence Growth Award"

Join our network of talented professionals!