Verify member and prescriber information and enter accurate data to support pharmacists and clinical programs
Educate members on pharmacy-related rules (formulary, prescription benefits), medication resources/assistance programs, and medication adherence aligned with STAR Ratings and HEDIS measures
Conduct phone and text-based outreach to members and providers to address care gaps, improve outcomes, and support quality initiatives
Provide support for grievances and appeals inquiries related to pharmacy services
Generate and maintain reports and records related to rebates, utilization, Beers Criteria, and other ad hoc or monthly reporting needs

Requires an active, professional license, if required by state law
State Pharmacy Technician Certification or National Certification based on applicable state(s) requirements
Requires H.S. diploma or equivalent
minimum of 2 years of pharmacy experience; or any combination of education and experience, which would provide an equivalent background
Currently active National Pharmacy Technician Certification and State Pharmacy Technician License preferred
Previous experience in call center environment preferred
strong oral, written and interpersonal communication skills
problem-solving skills
facilitation skills
analytical skills

Pharmacy Technician II

Key skills