Pharmacy Technician Specialist - Pharmacy Benefit Management

UNC Health Care Systems Durham , NC 27701

Posted 2 weeks ago

Position: Pharmacy Technician Specialist

Location: Main Hospital / Chapel Hill

Hours: Full Time, 40 hrs/wk; Days

The University of North Carolina Health Care System has an opening for a highly motivated individual interested in joining our team. We are looking for a Certified Pharmacy Technician to provide operational and administrative support as a PBM Operations Specialist. Managed Pharmacy Solutions consists of pharmacist-led Population Health Management through the Carolina Assessment of Medications Program (CAMP) Clinic and Pharmacy Benefit Management (PBM) services. The PBM Operations Specialist will work with a team of pharmacists, technicians, and analysts to provide daily support regarding such items as formulary maintenance, prior authorization processing, drug cost analysis, and benefits documentation/communication. The PBM Operations Specialist will also support the CAMP program through projects and other activities such as patient recruitment.

KEY RESPONSIBILITIES

  • Develop and maintain drug lists and clinical edits associated with the formularies and utilization management strategies.

  • Support the prior authorization program in all aspects including review of individual requests, communication of new and changing criteria, providing appropriate formulary alternatives, and working with physicians, patients and the claims adjudicator.

  • Coordinate the process of entering formulary information from various sources such as the Pharmacy and Therapeutics Committee for adjudication and communicating changes to the appropriate outlets

  • Maintain up-to-date member and physician facing formulary documentation and make it available through the appropriate channels.

  • Participate in and operationalize solutions to address inappropriate utilization, improve outcomes and optimize drug spend.

  • Respond to and resolve pharmacy-related inquiries from members, clients, providers, or pharmacies related to formulary options, therapeutic alternatives, and Prior Authorization determinations for covered health plans. Appropriately triage inquiries to a pharmacist when clinical expertise is required.

  • Understand drug pricing rules and programs and work to build cost effective and efficient strategies for reimbursement.

  • Effectively and accurately communicate with patients in a way that is compassionate and exemplifies the principles of Carolina Care.

  • Provide project support and complete other projects/initiatives as assigned.

PREFERRED SKILLS AND ATTRIBUTES

  • Communication Skills

  • Leadership Skills

  • Organizational Skills

  • Strong computer skills

  • Self-initiative

HS diploma or equivalent. Completion of an academic pharmacy technician training program preferred. Registration with the NC Board of Pharmacy. CPhT from PTCB unless enrolled in pharmacy school. One year of pharmacy technician experience required.


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