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Pharmacy Technician: Prior Authorization

Devoted Health

Devoted Health

Multiple locations
Posted on Monday, June 24, 2024

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States. And we've just started. So join us on this mission!

Job Description

A bit about this role:

In this Pharmacy Technician role at Devoted you will support the medical management operations of the health plan. You’ll be an important part of helping us build strong relationships with network health care providers through outreach and follow-up communication. This is a fast paced company that will come with ebb, flows and last minute changes. A successful candidate will be outgoing, detail-oriented and have a natural talent for customer service. We often require management of several tasks at once so enthusiasm and organization are key.

Responsibilities will include :

  • Reviewing and determining prior authorization requests based on company policies and decision trees.

  • Triaging/entering incoming prior authorization requests from provider offices.

  • Applying preferred product strategies and working with providers to steer utilization of our part B medication benefit.

  • Reaching out to hospitals and provider offices to obtain important clinical documentation.

  • Contacting provider groups and members to ensure communication of clinical decisions.

  • Addressing questions and concerns from members when alternative treatment options are needed.

  • Providing operational support for key medical management processes enabling yourself, pharmacists, and physicians to make efficient, high-quality decisions.

  • Acting as the main point of contact for both internal and external stakeholders in our workflows.

  • Providing support for offshore clinical partners who assist us in workflows.

  • Interpreting plan benefits and entering specialty pharmacy overrides for proper claim adjudication.

  • This role will be 8am - 5pm PST.

  • Weekend Rotation every 3-4 weeks.

Attributes to success:

  • Things move swiftly at a startup - enjoying a fast paced environment is key.

  • Love the details and organizational skills are a strong-suit.

  • Understanding urgency and having the ability to juggle multiple priorities.

  • You’re a problem solver by nature - schedules will change, things will come up, the printer will break, people will ask you for help.

  • You can see the process and ways to make it better.

  • Ability & agility to multitask - you may be asked to do several things and need to change plans mid day.

  • Great communication skills - you’ll be talking and faxing with providers, partners, and members.

  • You feel accountable for the work you’re responsible for.

  • A calming presence - sometimes the days are ‘hair on fire’ and you’ll be the person people turn to for support.

Required skills and experience:

  • Nationally Certified Pharmacy Technician (CPhT) with at least three years of work experience in this field.

  • Experience caring for Medicare patients.

  • Proficient in technology - you’ll be working in Gmail /G Suite.

Preferred skills and experience:

  • Bilingual in Spanish - Strongly Preferred

  • Experience with Medicare Part B operations (e.g. pharmacy help desk, utilization management, prior authorizations).

  • A history of being organized and having high attention to detail - it’s the little things that matter.

Salary range: $21.00 - $26.00 hourly

Our ranges are purposefully broad to allow for growth within the role over time. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered may depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Our Total Rewards package includes:

  • Employer sponsored health, dental and vision plan with low or no premium

  • Generous paid time off

  • $100 monthly mobile or internet stipend

  • Stock options for all employees

  • Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles

  • Parental leave program

  • 401K program

  • And more....

*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.

Healthcare equality is at the center of Devoted’s mission to treat our members like family. We are committed to a diverse and vibrant workforce.

Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.