Pharmacy Prior Authorization Technician Job Listing at Kelly Services in Rochester, NY (Job ID US3578628_BH9882287)

Description

Kelly® is seeking a Pharmacy Prior Authorization Technician to work at a top insurance client in the vibrant Rochester, NY area. Let us help you grow at work and discover the next step in your career, all while being a vital part of your community
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Salary/Pay Rate/Compensation: $20.50/hour

Summary Description: The Pharmacy Prior Authorization Technician provides essential functions that encompass initial level processing and review of prior authorization requests. These requests include both pharmacy and medical specialty drug reviews, utilizing pharmacy management drug policies and procedures. Responsibilities include preparing and interpreting cases for UM reviews and determination, acting as a content expert for processing applications, and serving as a resource regarding members' contract benefits. Essential Responsibilities/Accountabilities: Level I:

• Conduct medication prior-authorization and necessity reviews.
• Route cases directly to the pharmacist/medical director for final determination.
• Issue verbal and written member notifications as required.
• Review and interpret prescription and medical benefit coverage.
• Develop and implement process improvements for efficiency.
• Communicate with providers, clinical pharmacists, and internal staff.
• Act as a lead troubleshooter for the pharmacy help desk and customer care.
• Ensure appropriate authorization entry across all lines of business.
• Perform system testing for upgrades/enhancements to care management systems.
• Provide phone coverage for incoming calls related to UM processes.
• Support drug pricing queries using online resources.
• Maintain knowledge of health plan contracts and procedures.
• Produce and distribute information, track, and report department performance.
• Participate in interdepartmental coordination and communication.
• Maintain high standards of integrity and privacy according to corporate policies.
• Perform other functions as assigned by management.

Minimum Resource Qualifications: All Levels:

• High school diploma required; Associates degree preferred.
• Minimum two years' experience in health-related field.
• Pharmacy Technician certification (CPhT), LPN, or Medical Assistant/Technologist background preferred.

Physical Requirements:

• Ability to work prolonged periods sitting at a workstation.
• Ability to work while sitting/standing and using a computer/phone for extended hours.
• Typical office environment including fluorescent lighting.
• Ability to work in a home office for business continuity.
• Ability to travel for meetings and/or training as needed.
• Strong verbal communication skills.

What happens next:

• Once you apply, you'll proceed to next steps if your skills and experience look like a good fit. But don't worry—even if this position doesn't work out, you're still in our network.
• That means all of our recruiters will have access to your profile, expanding your opportunities even more.

Helping you discover what's next in your career is what we're all about, so let's get to work.
Apply to be a Pharmacy Prior Authorization Technician today!

As part of our promise to talent, Kelly supports those who work with us through a variety of benefits, perks, and work-related resources. Kelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account. In addition, employees are entitled to earn paid sick leave under the applicable state or local plan. Click here for more information on benefits and perks that may be available to you as a member of the Kelly Talent Community.

Get a complete career fit with Kelly®.

You're looking to keep your career moving onward and upward, and we're here to help you do just that. Our staffing experts connect you with top companies for opportunities where you can learn, grow, and thrive. Jobs that fit your skills and experience, and most importantly, fit right on your path of where you want to go in your career.

About Kelly

Work changes everything. And at Kelly, we're obsessed with where it can take you. To us, it's about more than simply accepting your next job opportunity. It's the fuel that powers every next step of your life. It's the ripple effect that changes and improves everything for your family, your community, and the world. Which is why, here at Kelly, we are dedicated to providing you with limitless opportunities to enrich your life—just ask the 300,000 people we employ each year.

Kelly is committed to providing equal employment opportunities to all qualified employees and applicants regardless of race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, age, marital status, pregnancy, genetic information, or any other legally protected status, and we take affirmative action to recruit, employ, and advance qualified individuals with disabilities and protected veterans in the workforce. Requests for accommodation related to our application process can be directed to the Kelly Human Resource Knowledge Center. Kelly complies with the requirements of California's state and local Fair Chance laws. A conviction does not automatically bar individuals from employment. Kelly participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S.

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