Meridian

  • Pharmacy Technician- PTCB Required

    Job Location US-MI-Detroit
    Job ID
    2018-6659
    Category
    Pharmacy
    Business Line
    MRx
  • Overview

    Who we are: 

     

    MeridianRx is a full-service Pharmacy Benefit Manager (PBM) committed to driving down costs and elevating quality. Our clients experience better quality outcomes, thanks to effective clinical support, patient education, and specialty pharmacy programs.  

     

    We work with a diverse range of clients, from members to healthcare providers to plan administrators. MeridianRx services clients across the country and our network continues to grow.   

     

    Our employees work hard, play hard, and give back. MeridianRx employees enjoy: Happy hours, special events, company sports teams, potlucks, Bagel Fridays, and volunteer opportunities. 

     

     

    A Day in the Life of a Clinical Pharmacy Technician:

    This position is responsible for providing clinical support for the MeridianRx Clinical Operations department surrounding clinical case review submissions. This includes preparing and researching clinical data for coverage determinations, prior authorizations, direct member reimbursement, point of sale determinations, and appeals. The Clinical Pharmacy Associate works under the direction of the department Director and/or Manager of Clinical Operations.   

    Responsibilities

    • Ensure accuracy of clinical evidence required for coverage determinations (CD), prior authorizations (PA), direct member reimbursement (DMR), and appeals, and track, monitor and effectively manage the dashboard queue
    • Have knowledge and be able to apply commonly-used concepts, practices, procedures and standards of care within Clinical Pharmacy operations
    • Assist clinical staff in gathering and researching required information, case work up, analyses, and patient communications including mail, fax, and phone
    • Discuss challenging cases with Clinical Pharmacy team, provide case work up, recommendations, and support to aide in the clinical case review process
    • Provide first line direction to pharmacy technicians/pharmacy specialists and consult with Pharmacists and Manager of Clinical Operations as required
    • Work with management to perform quality audits, address and identify opportunities for improvement, and implement plans to mitigate risk
    • Assist in resolution of member issues related to pharmacy prescriptions
    • Reach out to prescriber offices, pharmacies, and members to obtain additional clinical information to assist in clinical case review
    • Provide support and collaborate internally to resolve issues, improve processes, and create efficiencies
    • Act as a liaison between MeridianRx, providers, and the client related to authorization requests
    • Assist in daily Medicare Reject Report communications and review
    • Provide excellent customer service to all members, providers, and customers at all times exceed client service level agreements
    • Perform assigned tasks according to established guidelines
    • Reach out to members, providers, and pharmacies surrounding coverage determination and direct member reimbursement decisions
    • Ensure compliance with all company, state and federal rules and regulations
    • Maintain HIPAA standards and confidentiality of protected health information; consistently demonstrate compliance with HIPAA regulations, professional conduct and ethical practice
    • Perform other duties as assigned

    Qualifications

    What you can bring to Meridian:

    • High school diploma is required
    • Registered Pharmacy Technician who has successfully completed a Certified Pharmacy Technician training program is required
    • Nationally Recognized Certification and full license in applicable state is required. Limited and temporary licensures are not acceptable
    • License and certification must be in good standing
    • Two to 5 years of related experience and/or training in pharmacy prior authorization and pharmacy technician processes is preferred
    • Knowledge of drug products, dosage forms and usage, as well as retail pharmacy operations is preferred
    • Knowledge of medical and pharmaceutical terminology
    • Knowledge of managed care and authorization processes
    • Knowledge and/or experience in work teams 
    • Excellent customer service and interpersonal communication skills; maintains professional demeanor
    • Computer/data entry skills; proficient in data warehouse, database, word processing and spreadsheet applications
    • Detail-oriented with strong organizational skills
    • Telephone service skills
    • Ability to work with minimal management oversight on multiple projects with competing priorities
    • Ability to prioritize work and function under time constraints
    • Ability to work with confidential information
    • Ability and desire to work in a team atmosphere

    What MeridianRx can offer you: 

     

    • Healthcare benefits that include a variety of plans, which are effective on the first day of employment for our new full-time team members.   
    • Opportunity to work with the industry’s leading technologies and participate in unique projects, demonstrations, conferences, and exclusive learning opportunities.  
    • 401k matching that is above the national average.   
    • Full-time MeridianRx employees are eligible for tuition reimbursement towards Bachelor’s or graduate degrees.  
    • A bright and engaging company culture; the Meridian family of companies has been recognized as one of Metro Detroit’s Best and Brightest Companies to Work For 5 years in a row.   

     

    Equal Opportunity Employer

    #MSTR

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