Prior Authorization Pharmacy Technician

About the position Oscar is hiring a Prior Authorization Pharmacy Technician to join their Pharmacy Tech team. Oscar is a health insurance company that utilizes a full stack technology platform and focuses on serving its members. The role is dedicated to high-quality pharmacy decision-making and improving the member and provider experience. This position is responsible for processing prior authorizations requests and providing support for escalated issues related to prior authorizations.

Responsibilities

• Use Oscar and vendor tools to determine eligibility, screen for required documents, create, process, and properly track pharmacy prior authorization requests
• Prepare, organize, and distribute pharmacy prior authorization requests for review by pharmacist/physician and respond to pharmacist/physician requests for additional information
• Collect relevant medical information (via telephone, fax, and portal) and apply the appropriate PA criteria, clearly documenting all communication and decision making
• Meet required decision-making timeframes, including promptly triggering escalation for cases requiring pharmacist review
• Communicate oral and written prior authorization outcome notifications that comply with standards and requirements for content and accuracy
• Compliance with all applicable laws and regulations
• Other duties as assigned

Requirements

• 2+ years of work experience in a pharmacy related field in a retail or managed care plan setting and/or prior authorization experience
• Active, unrestricted Pharmacy Technician certification (CPhT)
• Excellent customer service, phone etiquette, and typing skills

Nice-to-haves

• 1+ years of performing pharmacy reviews for a managed care plan or pharmacy benefits manager
• Experience working with CVS Caremark's portal and criteria
• In-depth understanding of how to operationalize step therapy rules and regulations
• Strong verbal and written communications, and interpersonal interactions

Benefits

• medical
• dental
• vision benefits
• 11 paid holidays
• paid sick time
• paid parental leave
• 401(k) plan participation
• life and disability insurance
• paid wellness time and reimbursements
• monthly vacation accrual at a rate of 15 days per year

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