Pharmacy Services (Digital Support) TechnicianCambia Health Solutions • Pocatello, Idaho, United States
Pharmacy Services (Digital Support) Technician
Cambia Health Solutions
- Pocatello, Idaho, United States
- Pocatello, Idaho, United States
Über
Pharmacy Services Technician — Work from home within Oregon, Washington, Idaho or Utah. Build a career with purpose to create a person-focused and economically sustainable health care system. Who We Are Looking For
Every day, Cambia's dedicated Pharmacy Services Technician is a corporate-wide technical support resource for pharmacy benefit, reimbursement, and other drug use issues which do not require clinical judgment. This function assists the Clinical Pharmacy Consultants and Pharmacy Services staff with formulary-related operations and other operational processes which require knowledge and experience with pharmaceuticals, all in service of creating a person-focused health care experience. Do you have a passion for serving others and learning new things? Do you thrive as part of a collaborative, caring team? Then this role may be the perfect fit. Qualifications
What You Bring to Cambia: High school diploma or related certificate and 5 years of experience as a pharmacy services technician in a retail, hospital, or other licensed pharmacy setting, or equivalent combination of education and experience Pharmacy Technician Certificate may substitute for 2 years of experience (reducing requirement to 3 years) Additional requirements for Pharmacy Services Technician II: high school diploma or related certificate with 4 years of pharmacy technician experience in a retail, hospital, or licensed pharmacy setting. An equivalent combination of education and experience will be considered; a Bachelor's degree is preferred Skills And Attributes Knowledge of medical terminology, health care coding systems such as ICD-10, CPT and HCPCS, and HIPAA regulations Knowledge of pharmaceutical products, including orals, injectables, infusion products, and chemotherapy Knowledge of general office practices and procedures, and grammar and business communication Ability to interact effectively with a variety of health care professionals with maturity, tact, diplomacy, and persuasiveness Demonstrated ability to perform pharmaceutical pricing calculations and type 30 words per minute (60 wpm preferred) Proficiency with standard office equipment and basic computer programs (Word, Excel, etc.) Ability to organize, plan, and prioritize daily workflow and projects within time constraints; experience with health insurance or prescription benefits is preferred Experience with AI tools and technologies to enhance productivity and decision-making in professional settings Additional Skills And Attributes Ability to process Peer to Peer cases and perform complex PA set-up, including research, outreach, and coordination with PA clinical staff Advanced knowledge of medical terminology and pharmaceutical products with excellent verbal and written communication skills Ability to interpret policies and procedures, make decisions, and communicate complex topics effectively What You Will Do At Cambia
Perform all duties as described unless clinical judgment is required; seek assistance from appropriate medical personnel during normal business hours Respond to non-clinical pharmacy issues from providers and staff, including formulary drug coverage, appeals, reconsiderations, and pricing for drug claims Complete daily formulary operational processes, including tracking, processing, and obtaining documentation for pharmacy medical exception requests, prior authorization requests, reconsiderations, and appeals Prepare reconsideration requests for Clinical Pharmacy Consultant review and communicate information to providers and members as necessary Obtain and organize drug utilization data to facilitate clinical review and decisions by Clinical Pharmacist Consultants Assist with auditing and investigations of medication-related claims, cases, and providers to identify misuse or fraudulent billing practices Support wellness and disease state management programs contributing to NCQA accreditation and quality improvement efforts Additional Functions
Complete daily complex operational processes and manage documentation for complex requests while handling provider and member outreach Respond to non-clinical complex pharmacy issues and coordinate peer to peer requests and clinical staff consultations May mentor and/or train pharmacy technicians on systems, policies, and procedures as needed Compensation & Benefits
The remote role offers a hiring range for Pharmacy Services Technician of $20.50 - $26.80 per hour, plus a 5% bonus target; current full hourly range: $19.20 - $34.90. For Pharmacy Services Technician II, range is $23.00 - $26.80 per hour, with a 5% bonus target; current full hourly range: $21.60 - $33.90. Benefits
Medical, dental and vision coverage for employees and eligible dependents, including mental health benefits Annual employer contribution to a health savings account Generous paid time off and 10 company-paid holidays Market-leading retirement plan with company match; discretionary contribution based on company performance Up to 12 weeks of paid parental leave (eligibility requires 12 months of continuous service) Wellness programs and Employee Assistance Fund Commuting and parking benefits Learn More About Our Benefits. We offer work-from-home options for most roles with minimum connection requirements as stated. Cambia is an Equal Opportunity employer and a drug- and tobacco-free workplace. A background check is required. For accommodation during the application process, email CambiaCareers@cambiahealth.com. Privacy information is available in our Privacy Policy.
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Sprachkenntnisse
- English
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