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Clinical Pharmacy Technician

  • Magellan Health
  • Newport, RI, USA
  • Sep 14, 2017
ID: 8080104 VIEWS: 3 Full time Health Care

Job Description

Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.


* Determines appropriateness for medications. Communicates decision to physicians, physician?s office staff, medical management staff and/or pharmacists.
* Researches, resolves and documents prior authorization outcomes in pharmacy system.
* Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician?s office staff, medical management staff and/or pharmacists.
* Escalates requests to Pharmacist when request requires extensive clinical review or denial.
* Researches, resolves and documents physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management.
* Performs other duties as required.

General Job Information


Clinical Pharmacy Technician



Job Family

Call_Contact Center_Ph


United States of America

FLSA Status

United States of America (Non-Exempt)

Recruiting Start Date


Date Requisition Created


Minimum Qualifications


GED (Required), High School (Required)

License and Certifications - Required

CPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy

License and Certifications - Preferred

Other Job Requirements


* CPT: Certification/licensure in accordance with state requirements. In the states of Florida and Michigan, license registration with the Board of Pharmacy is required without exception.
* PTCB: Certification or the ability to obtain PTCB Certification within one year of hire. Employees in states which require a Pharmacy Technician certification/registration exam may substitute state certification/registration for the PTCB.
* Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.
* In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).
* Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.
* Excellent written and verbal communication skills.
* Ability to follow clinical criteria and instructions to approve prior authorization requests.
* Minimum of 6 months dispensing or retail experience required, or equivalent internal training will be substituted.
* Ability to identify and trouble-shoot problematic issues.



Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled

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