Address
Form of work
Coordinates and completes necessary forms related to pharmaceutical prior authorization, where appropriate. Contacts insurance companies to identify formulary alternatives that do not require prior authorization or can be provided to the patient at lower out-of-pocket cost, and relays recommendations to the providers. Assists with identifying patients that may benefit from comprehensive medication review to reduce polypharmacy and support safety and deprescribing efforts, where appropriate.
Tracks number of prior authorization requests submitted and number of recommendations made to providers (including acceptance rate). Reports data to Administrative Director of Provider Services and Assistant Vice President of Physician Services quarterly.
Reports to: Administrative Director of Provider Services
Minimum Qualifications:
High school graduate or equivalent. Current active Pharmacy Technician II licensure in state of Rhode Island. Minimum three (3) years of experience in retail or other pharmacy setting. Strong communication skills.
Success Factors:
Ability to work independently, managing work queues and communicating with the team, including providers, where appropriate, with minimal day to day oversight.
