Pharmacy Technician, Clinical Ops Remote
Molina Healthcare is hiring for a Pharmacy Technician, Clinical Operations. This role is 100% remote.
Ideal candidates will have experience in PBM and/or HealthPlan, along with above average skills in Excel and great written and verbal communication. This role's primary responsibility will be to ensure the company is meeting all state requirements.
Job Summary
Molina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal and state laws. Jobs in this family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services (such as, therapeutic drug monitoring, drug regimen review, patient education, and medical staff interaction), and oversight (establishing and measuring performance metrics with regard to patient outcomes, medications safety and medication use policies).
Job Duties
Accurately and efficiently submits claim system and PBM prior authorization system configuration updates related to pharmacy and medical benefit.
Participates in the development /administration of programs designed to enhance the utilization of targeted drugs and the identification of cost saving pharmacy practices.
Identifies and reports departmental operational issues and resource needs to appropriate management.
Performs analyses related to formulary design, utilization management, benefit validation, and prior authorization requirements.
Prepares and assembles reports and presentations by gathering data and interpreting data using PowerPoint, Excel, etc. for team leader review and distribution.
Serves as recording secretary for committee(s), scheduled meetings, distributing materials, recording, and transcribing meeting minutes.
Assists Molina Member Services, pharmacies, and health plan providers in resolving member prescription claim, prior authorization, or pharmacy services access issues.
Articulates Pharmacy Management policies and procedures to pharmacy/health plan providers, other Molina staff and others as needed.
REQUIRED EDUCATION: Associates degree
REQUIRED EXPERIENCE: 4+ years' experience as a Pharmacy Technician
REQUIRED LICENSE, CERTIFICATION, ASSOCIATION: Active Pharmacy Technician Certification
PHYSICAL DEMANDS:
Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Key Words: Pharmacy, Pharm Tech, Pharmacy Tech, Pharmacy Technician, Member, Molina, pharmacies, health plan, provider, claim, claims, PA, prior Auth, PBM, Excel, Microsoft, policy, policies, managed care, MCO
Apply Now
Ideal candidates will have experience in PBM and/or HealthPlan, along with above average skills in Excel and great written and verbal communication. This role's primary responsibility will be to ensure the company is meeting all state requirements.
Job Summary
Molina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal and state laws. Jobs in this family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services (such as, therapeutic drug monitoring, drug regimen review, patient education, and medical staff interaction), and oversight (establishing and measuring performance metrics with regard to patient outcomes, medications safety and medication use policies).
Job Duties
Accurately and efficiently submits claim system and PBM prior authorization system configuration updates related to pharmacy and medical benefit.
Participates in the development /administration of programs designed to enhance the utilization of targeted drugs and the identification of cost saving pharmacy practices.
Identifies and reports departmental operational issues and resource needs to appropriate management.
Performs analyses related to formulary design, utilization management, benefit validation, and prior authorization requirements.
Prepares and assembles reports and presentations by gathering data and interpreting data using PowerPoint, Excel, etc. for team leader review and distribution.
Serves as recording secretary for committee(s), scheduled meetings, distributing materials, recording, and transcribing meeting minutes.
Assists Molina Member Services, pharmacies, and health plan providers in resolving member prescription claim, prior authorization, or pharmacy services access issues.
Articulates Pharmacy Management policies and procedures to pharmacy/health plan providers, other Molina staff and others as needed.
REQUIRED EDUCATION: Associates degree
REQUIRED EXPERIENCE: 4+ years' experience as a Pharmacy Technician
REQUIRED LICENSE, CERTIFICATION, ASSOCIATION: Active Pharmacy Technician Certification
PHYSICAL DEMANDS:
Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Key Words: Pharmacy, Pharm Tech, Pharmacy Tech, Pharmacy Technician, Member, Molina, pharmacies, health plan, provider, claim, claims, PA, prior Auth, PBM, Excel, Microsoft, policy, policies, managed care, MCO
Apply Now