Description:
Reviews requests for medical policy or prescription drugs that require a coverage determination based on pre-determined clinical criteria. Provides guidance to providers (doctors and nurses) as well as pharmacies with regard to pharmacy benefits, pharmacy claims, formulary, and pharmacy policy and procedures. Will not be talking to members.
Additional Skills & Qualifications:
3 years recent Pharmacy Technician experience that includes familiarity with drugs and drug categories, pharmacy benefits, pharmacy claims, and working with difficult customers in-person and via telephone; or 3 years Prior Authorization and pharmacy benefit experience at a pharmacy benefit company or health plan. Most important factor is being extremely comfortable with drug familiarity.
6 months experience with computer systems in pharmacy services. Need to be able to pick up repeatable processes quickly.
Registration as a pharmacy technician in Minnesota - Verify this is active and in good standing at https://pha.hlb.state.mn.us/#/onlineEntitySearch
Highly Preferred:
Completion of a Pharmacy Technician Program
Certification as a Pharmacy Technician (CPhT)
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
Diversity, Equity & Inclusion
At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:
- Hiring diverse talent
- Maintaining an inclusive environment through persistent self-reflection
- Building a culture of care, engagement, and recognition with clear outcomes
- Ensuring growth opportunities for our people
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.