Elevance Health
Pharmacy Technician III Dispensing
A proud member of the Elevance Health family of companies, CarelonRx (formerly IngenioRx) leverages the power of new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care. Location Hybrid 1: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. The Pharmacy Technician III Dispensing is responsible to 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. Responsible for complex pharmacy, patient, and prescriber encounters, including, but not limited to prescription claim adjudication exceptions, returns, reships, drug recalls, and patient and prescriber escalations. How you will make an impact: Educates members on pharmacy-based rules related to prescriptions and medication resources or assistance programs. Serves as the subject matter expert, proactively manages service failures and workflow in our contact center tool and our prescription processing system. Partner and support pharmacists in the performance of their duties, including outreach to patients and prescribers for resolution on open issues. Processes prior authorization requests from physicians and ensures compliance with all regulatory requirements; informs relevant parties of all prior authorization determinations. Provides resolution to grievances and appeals issues. Managing inbound and outbound communications, triaging and problem-solving pharmacy inquiries, ensuring any related patient and prescriber communication is completed and resolving all related open cases across patient services tool and pharmacy processing system, and managing prescription queue workflow. Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits. Generates reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports. Mentor and train lower-level pharmacy technicians as needed; as well as lead pharmacy technicians working prescription queue-based assignments to ensure quality, meeting turnaround times, and delivering on patient, prescriber, and client experience and expectations. Minimum Requirements: Requires H.S. diploma or equivalent and minimum of 5 years of pharmacy experience. Requires an 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. Preferred Skills, Capabilities, and Experiences: National CPhT certification highly preferred. Experience with PBM/Plan insurance setup, including but not limited to the processing of claims adjudication and resolution of reject messaging strongly preferred. Experience in dispensing pharmacy setting preferred. For URAC accredited areas, the following professional competencies strongly preferred: strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
A proud member of the Elevance Health family of companies, CarelonRx (formerly IngenioRx) leverages the power of new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care. Location Hybrid 1: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. The Pharmacy Technician III Dispensing is responsible to 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. Responsible for complex pharmacy, patient, and prescriber encounters, including, but not limited to prescription claim adjudication exceptions, returns, reships, drug recalls, and patient and prescriber escalations. How you will make an impact: Educates members on pharmacy-based rules related to prescriptions and medication resources or assistance programs. Serves as the subject matter expert, proactively manages service failures and workflow in our contact center tool and our prescription processing system. Partner and support pharmacists in the performance of their duties, including outreach to patients and prescribers for resolution on open issues. Processes prior authorization requests from physicians and ensures compliance with all regulatory requirements; informs relevant parties of all prior authorization determinations. Provides resolution to grievances and appeals issues. Managing inbound and outbound communications, triaging and problem-solving pharmacy inquiries, ensuring any related patient and prescriber communication is completed and resolving all related open cases across patient services tool and pharmacy processing system, and managing prescription queue workflow. Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits. Generates reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports. Mentor and train lower-level pharmacy technicians as needed; as well as lead pharmacy technicians working prescription queue-based assignments to ensure quality, meeting turnaround times, and delivering on patient, prescriber, and client experience and expectations. Minimum Requirements: Requires H.S. diploma or equivalent and minimum of 5 years of pharmacy experience. Requires an 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. Preferred Skills, Capabilities, and Experiences: National CPhT certification highly preferred. Experience with PBM/Plan insurance setup, including but not limited to the processing of claims adjudication and resolution of reject messaging strongly preferred. Experience in dispensing pharmacy setting preferred. For URAC accredited areas, the following professional competencies strongly preferred: strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.