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The Specialty Operations Pharmacy Technician 2 performs varied activities and moderately complex administrative/technical/operational/customer support assignments. Typically work on semi-routine assignments and daily follow ups. Work with providers offices and insurance to troubleshoot and complete medication prior authorization requests for specialty medications.
$1,500 Sign-On Bonus ($750 upon hire and a second $750 payment after completing 6 months (180 days) of employment)

The Specialty Operations Pharmacy Technician 2 (Prior Authorizations) will oversee the following:

• Manage daily worklists, conducting follow-ups, and prioritizing authorization requests.
• Research and interpret insurance claims, while using a broad array of clinical and informational resources to obtain relevant authorization information.
• Work directly with physician offices to initiate and complete prior authorization requests, ensuring compliance with quality standards and departmental protocols.
• Operate with opportunities for independent discretion and interpretation within established guidelines, supporting the delivery of high-quality patient care and operational excellence.

Use your skills to make an impact
 

Required Qualifications

• Must have an active license with the Board of Pharmacy in the state of residence (Ohio, Florida, Texas or Arizona).
• Must be certified by the Pharmacy Technician Certification Board (PTCB) or through ExCPT with an active certification.
• Must be able to research, read & interpret clinical information.
• Critical thinker who can anticipate member/customer needs and take initiative, ask the right questions and deliver the highest quality customer experience.
• Problem solver who can find viable solutions that meets member/customer needs, absent from all ideal tools.
• Experience using multiple applications simultaneously and data entry skills.

Preferred Qualifications

• 2+ years of experience as a Pharmacy Technician OR call center experience in a pharmacy or related call center setting.
• Mail Order Pharmacy or Specialty Pharmacy experience.
• Experience working with insurance plans and Medicare.
• 1+ years of experience submitting and reading pharmacy claims, in RxNova.
• Experience with Scriptmed.

Additional Information

Hours: The preferred hours of operation for this position will be an 8-hour shift sometime between the hours 8 a.m.-5:30 p.m. EST

• Overtime: When there is a business need, overtime will be requested. Potentially voluntary or mandatory.
• Holidays: When there is a business need to work on a holiday outside of Thanksgiving day and Christmas Day, there is the possibility of working on a holiday.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$40,000 - $52,300 per year

 

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us
 

About CenterWell Pharmacy: CenterWell Pharmacy provides convenient, safe, reliable pharmacy services and is committed to excellence and quality. Through our home delivery and over-the-counter fulfillment services, specialty, and retail pharmacy locations, we provide customers simple, integrated solutions every time. We care for patients with chronic and complex illnesses, as well as offer personalized clinical and educational services to improve health outcomes and drive superior medication adherence.

About CenterWell, a Humana company: CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high-quality healthcare that is accessible, comprehensive and, most of all, personalized. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. CenterWell is part of Humana Inc. (NYSE: HUM). Learn more about what we offer at CenterWell.com.

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Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.