Pharmacy Technician, Advanced

JOB DESCRIPTION
Your Role

The Federal Employee Program (FEP) Pharmacy Technician team is primarily responsible for assisting pharmacists with drug utilization review programs, quality and medication adherence programs or other assigned projects. The Pharmacy Technician, Advanced, will report to the FEP Utilization Management Clinical Manager. In this role you will evaluate and authorize medication prior authorization and post claim requests within technician extension of authority (EOA). Provide support for staff pharmacists using operational expertise to prepare medication cases for clinical review outside of technician EOA. Ensure compliance with various regulatory and quality accreditation requirements around drug utilization management. Conduct courteous and professional telephonic outreach to members, prescribers, and pharmacies related to medication safety, appropriate medication use, and medication treatment options that are less costly.

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
• Work in team environment to manage queues
• Demonstrate the ability to maintain individual work queue
• Provide drug usage history and other pertinent pharmacy benefit related inquiries to internal business partners to assist in case specific reviews and drug evaluations
• Communicate with the physician, physician’s office staff, pharmacies, and internal business partners to assist with accurate and efficient resolution of medical benefit and pharmacy benefit inquiries
• Communicate formulary alternatives and prior authorization criteria, and discuss medication benefit coverage when required
• Provide formulary alternatives, member drug profiles, communicate prior authorization criteria, and other pertinent medication benefit related information to authorized individuals upon request
• Use motivational interviewing, educate members about medication use issues such as medication adherence
• Respond to inquiries requiring knowledge of FEP clinical programs
• Serve as a resource to internal and external constituents regarding the FEP drug formulary and medication coverage requirements
• Ensure work is performed according to established policies, procedures, and timelines to meet all business and regulatory requirements
• Demonstrate ability to communicate well with other team members and help to create team synergies
• Participate in, evaluate and maintain efficient workflow procedures
• Perform other duties as assigned by the Management Team

QUALIFICATIONS
Your Knowledge and Experience

• Requires a Certified Pharmacy Technician license
• Requires 4 years of pharmacy related experience and training; or equivalent combination of education and experience
• Requires basic job knowledge of systems and procedures obtained through prior work experience or education
• Excellent interpersonal and professional skills
• Excellent problem-solving skills
• Excellent verbal and written communication skills
• Excellent customer service and phone skills

Pay Range:

The pay range for this role is: $22.69 to $31.77 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.

ABOUT THE TEAM
Blue Shield of California’s mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our continued commitment to diversity, equity, and inclusion upholds our values and advances our goal of creating a healthcare system that is worthy of our family and friends while addressing health disparities, promoting social justice, and integrating health equity through our products, business practices, and presence as a corporate citizen.

Blue Shield has received awards and recognition for being a certified Fortune 100 Best Companies to Work, Military Friendly Employer, People Companies that Care, a Leading Disability Employer, and one of California’s top companies in volunteering and giving. Here at Blue Shield, we strive to make a positive change across our industry and communities – join us!

Our Values:

• Honest . We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short.
• Human . We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes.
• Courageous . We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

Our Workplace Model:

Blue Shield of California is dedicated to making work-life balance a reality. Whether you prefer to work in an office or from home, we understand flexibility is more important than ever. That’s why Blue Shield is a hybrid company, offering you the opportunity to decide where you can do your best and most meaningful work.

Two ways of working: Hybrid (our default) and office

• Hybrid – In a business unit approved office a few times per year to 3 days per week, on average

• Office – In a business unit approved office 4+ days a week, on average. If the role you’re applying for is deemed an “Essential Role,” the company has determined that the role can only be performed in a Blue Shield office or in the field and would require your to meet the office worker classification.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Due to the current public health emergency in California, Blue Shield employees are almost all working remotely. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Equal Employment Opportunity:

External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.