Oversee and administer pharmacy benefits for Sutter Health's value based pharmacy health plan services
Serve as a pharmacy benefit and drug coverage subject matter expert
Review pharmacy-related appeals and grievances by conducting clinical reviews
Develop compliant administrative determinations
Resolve escalated member issues
Educate members and internal stakeholders on appropriate use of benefits and resources
Support workflow and desk-level-procedure development, maintenance, and optimization

Graduate of an accredited pharmacy technician program
PHARMC-Certified Pharmacy Technician
2 years recent relevant experience
Knowledge of data fields required by NCPDP
Ability at running ad hoc reports from pharmacy claims data
Strong PC skills including PowerPoint, Access, Outlook, Excel and Word
Knowledge of HIPAA, Health Care Reform, Business Code of Ethics and government regulated programs
Ability to work collaboratively, prioritize functions, problem solve, and anticipate upcoming issues for the executives

Pharmacy Technician Analyst III

About this role