Pharmacy Prior Authorization Technician Job Listing at Kelly Services in Greece, NY (Job ID US3578622_BH9881823)

Description

Kelly® is looking for a Pharmacy Prior Authorization Technician to work at a top insurance client in the vibrant Rochester, NY area. Let us help you grow at work and discover the next step in your career, all while being a vital part of your community

Location: Rochester, NY/Greece, NY
Pay Rate: $20.50/hour
Hours: M-F 8am to 5pm 

Summary Description:
The Pharmacy Prior Authorization Technician is responsible for the initial level processing and review of prior authorization requests for both pharmacy and medical specialty drug reviews. This role requires thorough application of pharmacy management drug policies and procedures to prepare and interpret cases for utilization management reviews. As a content expert, the Technician supports staff with member-specific contract benefits and engages in leadership within the prior authorization process for medications processed through pharmacy or medical benefits. The Technician also manages exception/prior authorization requests according to standard protocols.
Essential Responsibilities/Accountabilities:

• Conduct initial level medication prior-authorization, exception, and medical necessity reviews.
• Route cases to the pharmacist/medical director for final determination.
• Issue verbal and written notifications to members as required.
• Review and interpret prescription and medical benefit coverage to determine the necessary prior authorization review.
• Implement process improvements to increase efficiency in clinical staff review processes.
• Collaborate with providers, clinical pharmacists, and internal staff for criteria approval according to policy.
• Contact pharmacies and physician offices to clarify prior authorization requests.
• Coordinate pharmacy or medical claims with prior authorization information.
• Ensure accurate authorization entry across all lines of business and manual manipulation when necessary.
• Perform system testing for upgrades and enhancements to the care management system.
• Act as a content expert for internal and external customers regarding prior authorization intake.
• Provide phone coverage for incoming authorization inquiries and related requests.
• Support drug pricing questions using online resources.
• Maintain knowledge of health plan contracts, riders, policy statements, and procedures.

Minimum Resource Qualifications:

• High school diploma with minimum two years of experience in health-related field; Associates degree preferred.
• Pharmacy Technician certification (CPhT), LPN, or Medical Assistant/Technologist background strongly preferred.

Physical Requirements:

• Ability to work sitting at a workstation on a computer for extended periods.
• Ability to work in typical office environment and home office as needed.
• Ability to travel across the Health Plan service region for meetings and trainings.
• Clear communication using a phone, with or without headset.

What happens next:

• Once you apply, you'll proceed to next steps if your skills and experience look like a good fit. But don't worry—even if this position doesn't work out, you're still in our network.
• That means all of our recruiters will have access to your profile, expanding your opportunities even more.

Helping you discover what's next in your career is what we're all about, so let's get to work.
Apply to be a Pharmacy Prior Authorization Technician today!

As part of our promise to talent, Kelly supports those who work with us through a variety of benefits, perks, and work-related resources. Kelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account. In addition, employees are entitled to earn paid sick leave under the applicable state or local plan. Click here for more information on benefits and perks that may be available to you as a member of the Kelly Talent Community.

Get a complete career fit with Kelly®.

You're looking to keep your career moving onward and upward, and we're here to help you do just that. Our staffing experts connect you with top companies for opportunities where you can learn, grow, and thrive. Jobs that fit your skills and experience, and most importantly, fit right on your path of where you want to go in your career.

About Kelly

Work changes everything. And at Kelly, we're obsessed with where it can take you. To us, it's about more than simply accepting your next job opportunity. It's the fuel that powers every next step of your life. It's the ripple effect that changes and improves everything for your family, your community, and the world. Which is why, here at Kelly, we are dedicated to providing you with limitless opportunities to enrich your life—just ask the 300,000 people we employ each year.

Kelly is committed to providing equal employment opportunities to all qualified employees and applicants regardless of race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, age, marital status, pregnancy, genetic information, or any other legally protected status, and we take affirmative action to recruit, employ, and advance qualified individuals with disabilities and protected veterans in the workforce. Requests for accommodation related to our application process can be directed to the Kelly Human Resource Knowledge Center. Kelly complies with the requirements of California's state and local Fair Chance laws. A conviction does not automatically bar individuals from employment. Kelly participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S.

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