Pharmacy Technician III - CarelonRx at Elevance Health

Indianapolis, Indiana, United States

Apply Now

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, valid, current, and unrestricted state Pharmacy Technician license or national license 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
Multi-state certification required if providing services in multiple states
For URAC accredited areas, strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills strongly preferred
Certified Pharmacy Technician preferred

Responsibilities

Verifies member and provider information and inputs data for pharmacists and other clinicians to review
Processes prior authorization requests from physicians’ offices and ensures compliance with all Medicaid, Commercial, and Medicare requirements; informs relevant parties of all prior authorization determinations
Manages inbound and outbound communications, triaging and problem-solving pharmacy inquiries, ensuring related patient and prescriber communication is completed, resolving all related open cases across patient services tool and pharmacy processing system, and managing prescription queue workflow
Manages and supports more complex inquiries and supports other lower-level pharmacy technicians
Provides resolution to grievances and appeals issues
Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits
Manages escalations and analyzes data and results of any process improvements
Generates reports related to necessary data for respective department, as well as other ad hoc reports as needed
Works in applicable queues, supporting clinicians and operations leadership with inbound requests in all lines of business
Acts as a subject matter expert in all respective areas and lines of business and maintains knowledge of new tasks to ensure continued education and support
Mentors and trains lower-level pharmacy technicians as needed
Interpretation and data entry of complex prescriptions, prior authorization processing, and troubleshooting adjudication issues
Reviews requests by mail, telephone, or electronically and responds to inquiries and interprets requests to determine the most effective response

Skills

Key technologies and capabilities for this role

Pharmacy TechnicianPrior AuthorizationPrescription Data EntryAdjudication TroubleshootingMedicaid ComplianceMedicare RequirementsPatient ServicesGrievances and AppealsFormulary ManagementProcess ImprovementsEscalation Management

Questions & Answers

Common questions about this position

Is this position remote or does it require office work?

This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.

What are the minimum qualifications for this role?

Requires H.S. diploma or equivalent and minimum of 5 years of pharmacy experience, plus an active, valid, current and unrestricted state Pharmacy Technician license or national license based on applicable state(s) requirements. Multi-state certification is required if providing services in multiple states.

What salary or compensation does this position offer?

This information is not specified in the job description.

What does the company culture or work environment emphasize?

The role promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development, while CarelonRx leverages new technologies and a clinical-first lens for member-centered pharmacy care.

What makes a strong candidate for this Pharmacy Technician III role?

Candidates with 5+ years of pharmacy experience, required licensing including multi-state certification if applicable, and the ability to handle complex inquiries, mentor lower-level techs, and act as a subject matter expert stand out.

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.

Land your dream remote job 3x faster with AI

Try Jobo Free