Submission for the position: Supervisor, Pharmacy Technicians (Appeals) - Tampa, FL - (Job Number: 1193168)
https://centene.taleo.net/careersection/jobdetail.ftl?job=1193168&lang=en
Supervisor, Pharmacy Technicians (Appeals) - Tampa, FL
Position Purpose:
• Track and triage all coverage determination requests for prior authorizations and Medicare Part D recipients. Ensure proper workflow and processes to optimize productivity and meet departmental goals.
• Monitor daily performance and create reports and audit findings to ensure optimal performance is achieved
• Ensure provider notification letters are communicated accurately and in a timely manner
• Monitor incoming calls for quality control checks and provide recommendations for improvement
• Communicate with providers and pharmacies to advise clinical outcome of prior authorization request
• Oversee multiple pharmacy systems to track and triage prior authorization requests for Medicaid and coverage determination requests for Medicare D recipients and determine if a pharmacist review is required
• Assist with complex coverage approvals and determination requests based on defined criteria
• Develop and deliver training materials for pharmacy technicians on the prior authorization process for Medicaid, Medicare D regulations and other related policies and procedures
• Work weekend or alternative shifts as needed
Education/Experience:
High school diploma or equivalent. Associate's degree preferred. 4 years of pharmacy technician experience in a mail order prescription facility, hospital pharmacy or retail pharmacy setting. Previous experience as a lead in a functional area or managing cross functional teams on large scale projects.
License/Certification:
Current state’s Pharmacy Technician license and National Certification from Pharmacy Technician Certification Board (CPhT).
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
USA-Florida-Tampa
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Schedule: Full-time Location(s): USA-Florida-Tampa