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Form of workWe are currently hiring a Pharmacy Technician, flexible work options available! If you are a certified Pharmacy Technician, possess a strong attention to detail, enjoy working in a fast-paced environment, and value being part of a team that makes a difference, you may be the right person for the position! Apply today!
JOB SPECIFICATIONS
Classification: NON-EXEMPT | Status: FULL-TIME, Monday - Friday, generally 8am to 5pm, Pacific Time
Salary: $19.00 - $23.44/HOUR
Department: PHARMACY | Work Location: COOS BAY, LOCAL TO COOS COUNTY
Reports to: DIRECTOR OF PHARMACY SERVICES
Supervision Exercised: NON-SUPERVISORY
JOB PURPOSE: Pharmacy Authorization
Responsible for the assessment and evaluation of requests for pharmaceutical products. Promotes quality, cost-effective care outcomes while ensuring the appropriate implementation of quality assurance, policies and procedures, Oregon Health Plan and other regulatory requirements.
QUALIFICATIONS, EDUCATION, and EXPERIENCE
JOB SPECIFICATIONS
Classification: NON-EXEMPT | Status: FULL-TIME, Monday - Friday, generally 8am to 5pm, Pacific Time
Salary: $19.00 - $23.44/HOUR
Department: PHARMACY | Work Location: COOS BAY, LOCAL TO COOS COUNTY
Reports to: DIRECTOR OF PHARMACY SERVICES
Supervision Exercised: NON-SUPERVISORY
JOB PURPOSE: Pharmacy Authorization
Responsible for the assessment and evaluation of requests for pharmaceutical products. Promotes quality, cost-effective care outcomes while ensuring the appropriate implementation of quality assurance, policies and procedures, Oregon Health Plan and other regulatory requirements.
QUALIFICATIONS, EDUCATION, and EXPERIENCE
- High School Diploma or equivalent required
- Current Certified Oregon Pharmacy Technician License preferred, will consider applicant that has three to five year’s of related healthcare experience such as a medical assistant
- Managed care or insurance setting experience a plus
ESSENTIAL RESPONSIBILITIES: Pharmacy Authorization
- Coordinates, assists, and supports implementation of procedures and guidelines for the drug prior- authorization program.
- Serves as a point of contact for providers and members in the Medical Management process by telephone or other correspondence.
- Communicates prior-authorization criteria and discusses pharmacy benefit coverage inclusions/exclusions when required.
- Provides drug usage history and other pertinent pharmacy benefit related computer reports for pharmacists and physician reviewers to assist in case specific reviews and drug evaluations.
- Assists Pharmacy Director with drug utilization review programs or other assigned projects.
- Researches and resolves physician inquiries and grievances.
- Provides information to internal staff to resolve member inquiries and grievances, assists with formulary requests, medication questions, and claims history inquiries.
- Participates in, evaluates, and maintains efficient workflow procedures in accordance with the Pharmacy Department’s goals and objectives.
- Assists in ensuring members are effectively and efficiently managed through the Medical Management process as needs require.
- Work with local pharmacies to coordinate care for members.
- Within extension of authority, approves pharmaceutical services.
- Creates worksheets and assists team members in the preparation of cases or in requesting additional information for care coordination, pre-service requests, and medical authorizations.
- Participate in quality and organizational process improvement activities and teams when requested.
- Assist audit preparation when focus is pharmacy related.
- Participate in quality and organizational process improvement activities and teams when requested.
- Ensure compliance with company policies and procedures as applicable to area(s) of responsibility.
- Handle confidential information and materials appropriately and maintain a secure work area.
- Other duties as assigned.
ESSENTIAL RESPONSIBILITIES: ORGANIZATIONAL TEAM MEMBER
- Participate in quality and organizational process improvement activities and teams when requested
- Support and contribute to effective safety, quality, and risk management efforts by adhering to established; policies and procedures, maintaining a safe environment, promoting accident prevention, and identifying and reporting potential liabilities
- Openly, clearly, and respectfully share and receive information, opinions, concerns, and feedback in a supportive manner
- Work collaboratively by mentoring new and existing co-workers, building bridges, and creating rapport with team members across the organization
- Provide excellent customer service to all internal and external customers, which includes team members, members, students, visitors, and vendors, by consistently exceeding the customer’s expectations
- Recognize new developments and remain current in [position’s expertise] best practice standards and anticipate organizational modifications
- Advance personal knowledge base by pursuing continuing education to enhance professional competence
- Promote individual and organizational integrity by exhibiting ethical behavior to maintain high standards
- Represent organization at meetings and conferences as applicable
KNOWLEDGE, SKILLS, and ABILITIES
- Knowledge of diagnoses and appropriate care modalities
- Knowledge of ICD, CPT and HCPCS codes, health insurance benefits and exclusions, and State and Federal mandates
- Proficiency in the use of the organization’s transactional software
- Adept at conducting research into project-related issues and products
- A certain degree of creativity and latitude is required
- Must be able to evaluate a situation and make appropriate decisions and work to control costs
- Must have attention to detail and exceptional problem-solving skills for processing of complex pharmaceutical requests
- Ability to work at a rapid pace, being involved in several duties at one time
- Ability to report to work as scheduled, and willingness to work a flexible schedule when needed
- Proficient in Microsoft Office Suite and Windows Operating System (OS)
- Training in or awareness of Health Literacy, Poverty Informed, Systemic Oppression, language access and the use of healthcare interpreters, uses of data to drive health equity, Cultural Awareness, Trauma-Informed Care, Adverse Childhood Experiences (ACEs), Culturally and Linguistically Appropriate Service (CLAS) Standards, and universal access
- Knowledge and understanding of how the positions’ responsibilities contribute to the department and company goals and mission
- Knowledge of federal and state laws including OSHA, HIPAA, Waste Fraud and Abuse
- Awareness and understanding of equity, diversity, inclusion, and the equity lens: ability to analyze the unfair benefits and/or burdens within a society or population by understanding the social, political, and environmental contexts of policies, programs, and practices
- Excellent people skills and friendly demeanor
- Critical thinking skills of using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems
- Organization skills
- Ability to handle stress and sensitive situations effectively while projecting a professional attitude
- Ability to communicate professionally, both conversing and written
- Ability to work with diverse populations and interact with people of differing personalities and backgrounds
- Sensitive to economic considerations, human needs and aware of how one’s actions may affect others
- Ability to organize and work in a sensitive manner with people from other cultures
- Poised; maintains composure and sense of purpose
WORKING CONDITIONS
This position must have the ability to remain in a stationary position, occasionally move about inside the office to access office machinery, printer, etc., frequently communicate and exchange accurate information.
Work Condition: hybrid work environment
This position must have the ability to remain in a stationary position, occasionally move about inside the office to access office machinery, printer, etc., frequently communicate and exchange accurate information.
Work Condition: hybrid work environment
- Employee generally works within the interior of an office or remote work from home environment.
- Employee may travel locally and be responsible for own transportation. Out of area travel may be required on occasion.
- Hours of operations and specific staff scheduling may vary based on operational need.
- The office environment is clean with a comfortable temperature and moderate noise level.
Exposed to:
Onsite: Cold/heat controls, close contact with employees and the public in office environment. Remote: Employee is responsible for maintaining a safe work environment that is conducive to successful productivity and work output.
Machines, equipment, tools, and supplies used: Constantly operates a computer or other office productivity machinery, such as postage machine, fax, copier, calculator, multi-line telephone system, scanner.
May answer a high volume of telephone calls, complete documentation, and use computer programs to either obtain or record information.
Multiple Duties: Must be able to work under conditions of frequent interruption and be able to stay on task.
This job description is intended to provide only basic guidelines for meeting job requirements. This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of DOCS Management Services employees. Other duties, responsibilities and activities may change or be assigned at any time with or without notice.
Onsite: Cold/heat controls, close contact with employees and the public in office environment. Remote: Employee is responsible for maintaining a safe work environment that is conducive to successful productivity and work output.
Machines, equipment, tools, and supplies used: Constantly operates a computer or other office productivity machinery, such as postage machine, fax, copier, calculator, multi-line telephone system, scanner.
May answer a high volume of telephone calls, complete documentation, and use computer programs to either obtain or record information.
Multiple Duties: Must be able to work under conditions of frequent interruption and be able to stay on task.
This job description is intended to provide only basic guidelines for meeting job requirements. This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of DOCS Management Services employees. Other duties, responsibilities and activities may change or be assigned at any time with or without notice.
