UM Pharmacy Technician-1

The UM Pharmacy Technician reviews and assesses prior authorization requests for medications under the medical benefit, making approval decisions based on clinical criteria. They communicate with providers, members, and work within regulatory guidelines as part of a multidisciplinary team.

Location: Greater New York City Area (NY, NJ, CT) or other approved locations

Salary: $41,101–$64,338 (NY, NJ, CT residents) / $41,101–$60,320 (other locations)

Responsibilities

• Reviews prior authorization requests and units for medications requested under the medical benefit
• Assesses provider-submitted clinical information for clinical appropriateness based on predetermined clinical criteria
• Sends notification to members and providers of authorization decisions via telephone, fax, or mail
• Ensures prior authorization reviews are conducted within timeframes set forth by CMS and/or NYSDOH
• Establishes rapport with Provider offices via telephonic communication
• Sends request for information sheets to Providers
• Ensures patient information is shared appropriately maintaining confidentiality and compliance with federal law and HIPAA regulations
• Additional duties as necessary

Requirements

• High School Diploma or GED from an accredited institution
• Either nationally certified Pharmacy Technician in good standing (i.e., PTCB, NHA) or registered or licensed Pharmacy Technician in good standing
• Experience conducting prior authorization reviews
• Experience requiring written, verbal, and telephonic communication in English that is clear, concise, grammatically correct, and professional

Benefits

• Medical, dental and vision coverage
• Incentive and recognition programs
• Life insurance
• 401k contributions

Additional Information

• Compliance & Regulatory Responsibilities: Noted above
• License/Certification: Nationally certified Pharmacy Technician in good standing (i.e., PTCB, NHA) or registered or licensed Pharmacy Technician in good standing