Your Role

The UMRx Prior Authorization Technician team is primarily responsible for ensuring accurate and timely review of IV and injectable medications under the medical benefit, using Blue Shield of California Pharmacy and Therapeutics (P&T) Committee medication polices. The Pharmacy Technician, Intermediate, will report to the Operations Supervisor. In this role you will provide support for staff pharmacists using operational expertise to prepare medication cases for clinical review outside of technician EOA. This role will also ensure compliance with various regulatory and quality accreditation requirements around drug utilization management.

Your Work

In this role, you will:

• Utilize medication policy and operational principles to make authorization determination on drug case reviews within technician extension of authority
• Research and collect pertinent patient and drug information to assist the pharmacists in case specific reviews and drug evaluations
• Ensure coverage determinations are completed within regulatory turnaround times for all lines of business
• Work in team environment to manage technician queues
• Demonstrate ability to maintain individual work queue
• Communicate with the physicians, physician's office staff, and pharmacies to assist with case resolution
• Demonstrate ability to communicate well with other team members and help to create team synergies
• Participate in, evaluate and maintain efficient workflow procedures
• Perform additional activities as assigned and discussed with manager, including participation in all workstreams within UMRx, including but not limited to, intake, system testing, and Peer to Peer
• Work a weekend and holiday rotation schedule
• Perform other duties as assigned by the Management Team

Your Knowledge

• Requires a Certified Pharmacy Technician license
• Requires at least 2 years of pharmacy experience and training; or equivalent combination of education and experience
• Demonstrated ability encompasses basic understanding of internal procedures and policies needed to ensure effective execution of assigned tasks
• Ability to multi-task, set priorities, and manage time effectively
• Strong phone and verbal communication skills along with active listening

Pay Range:

The pay range for this role is: $20.47 to $28.66 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.