Pharmacy Tech III Dispensing at Elevance Health

Mason, Ohio, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, PharmacyIndustries

Requirements

H.S. diploma or equivalent
Minimum of 5 years of pharmacy experience
Active, professional license, if required by state law(s)
State Pharmacy Technician Certification or National Certification based on applicable state(s) requirements, to practice as a Pharmacy Technician within the scope of practice in a state or territory of the United States
Experience with PBM/Plan insurance setup and processing and claims adjudication and resolution of reject messaging
For URAC accredited areas, strong oral and written communication skills strongly preferred

Responsibilities

Perform all pharmacy technician duties under the regulatory authority of the state they are practicing in and aid in the dispensing of prescriptions to patients by the CarelonRx Pharmacist
Handle complex pharmacy, patient, and prescriber encounters, including prescription claim adjudication exceptions, returns, reships, drug recalls, and patient and prescriber escalations
Educate members on pharmacy-based rules related to prescriptions and medication resources or assistance programs
Serve as the subject matter expert, proactively manage service failures and workflow in contact center tool and prescription processing system
Partner and support pharmacists in the performance of their duties, including outreach to patients and prescribers for resolution on open issues
Process prior authorization requests from physicians and ensure compliance with all regulatory requirements
Inform relevant parties of all prior authorization determinations
Provide resolution to grievances and appeals issues
Manage inbound and outbound communications, triage and problem-solve pharmacy inquiries, ensure related patient and prescriber communication is completed, resolve all related open cases across patient services tool and pharmacy processing system, and manage prescription queue workflow
Respond to inquiries from physicians, sales team, and members related to formulary and prescription benefits
Generate reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports
Mentor and train lower-level pharmacy technicians as needed; lead pharmacy technicians working prescription queue-based assignments to ensure quality, meeting turnaround times, and delivering on patient, prescriber, and client experience and expectations

Skills

Pharmacy Technician

Prescription Dispensing

Claim Adjudication

Drug Recalls

Patient Education

Prescriber Escalations

Returns Processing

Reships

Elevance Health

Integrated health services and digital platform

About Elevance Health

Elevance Health focuses on enhancing the health of individuals throughout their lives by evolving from a traditional health benefits organization into a comprehensive health partner. The company serves over 118 million people, providing support at every stage of health through an integrated approach that addresses a wide range of health needs. Their services are backed by advanced capabilities and a digital health platform that streamlines access to care. Unlike many competitors, Elevance Health emphasizes a holistic view of health, aiming to redefine health and improve community well-being. The ultimate goal is to make health improvements accessible to everyone.

Indianapolis, IndianaHeadquarters

1944Year Founded

$309.4MTotal Funding

IPOCompany Stage

Enterprise Software, Social Impact, HealthcareIndustries

10,001+Employees

Benefits

Medical, dental, & vision insurance

401(k) + match

Paid holidays

Paid Time Off

Incentive bonus programs

Stock purchase plan

Life insurance

Wellness Programs

Financial education resources

Adoption & Surrogacy Assistance

Dependent-care Flexible Spending Account (DCFSA)

Parental Leave

Parental Transition Week

Critical Caregiving Leave

Risks

Departure of CFO John Gallina may create a gap in financial leadership.

Lawsuit against CMS over MA Star Ratings could lead to financial penalties.

CareBridge integration may face operational challenges, disrupting service delivery.

Differentiation

Elevance Health integrates whole health approach with digital health platform for comprehensive care.

Acquisition of CareBridge enhances home health services within Carelon division.

Strategic partnership with Clayton, Dubilier & Rice aims to innovate primary care delivery.

Upsides

AI integration in home health services can reduce hospital readmissions and improve outcomes.

Predictive analytics support early disease detection, aligning with Elevance's whole health approach.

Telehealth expansion offers opportunities to reach more patients remotely.

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