[Hiring] Medication Prior Authorization Specialist I @Advocate Health

Role Description

• Completes area-specific work as outlined by standard processes, procedures and adherent to policies.
• Serves as an expert with equipment and technology in specialized area.
• Problem solves technical issues in the specialized area as they arise.
• Ensures documents and records are accurate and completed in a timely fashion.
• Supports methods of communication and coordination with patients and care team.
• Identifies quality improvement opportunities based on specialized skill set to ensure safe, effective, and efficient services and patient care.
• Provides input to and supports implementation of operational changes, advancements, and site and system standardization.
• Participates in site or system specialized work teams, committees, and councils, as applicable.
• Complies with legal, regulatory, and accreditation standards.
• Keeps current with changes in the specialized field and collaborates with department leadership to adopt best practices.
• Maintains updated knowledge and skills and contributes to the education of others.
• Contributes positively to execution of pharmacy department initiatives.
• Accepts assignments of tasks from other pharmacy teammate roles when workload dictates.

Qualifications

• Registration/Licensure with state board of pharmacy per state of employment requirements.
• Certification through Pharmacy Technician Certification Board (CPhT) or National Health Career Association (ExCPT).
• High school diploma or GED equivalent.
• For technicians in NC with validating technician responsibilities - an Associate’s Degree in Pharmacy Technology is required.

Requirements

• Typically requires 3 years of experience in health care, insurance industry, pharmacy, or medical background.
• Excellent oral, written, interpersonal, and customer service skills.
• Must be able to speak and be understood by others to communicate effectively.
• Critical thinking and problem-solving skills.
• Basic math skills.
• Strong background in medical terminology preferred.
• Organizational skills and analytical ability to prepare reports and reconcile reports correctly.
• Ability to evaluate and measure customer needs – set clear standards to ensure needs are met.
• Ability to maintain strict confidentiality.
• Self-discipline and attention to detail.
• Working PC knowledge including Microsoft Office Suite (Word, Excel and Outlook), Internet, and general Call Center Systems.

Benefits

• Paid Time Off programs.
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability.
• Flexible Spending Accounts for eligible health care and dependent care expenses.
• Family benefits such as adoption assistance and paid parental leave.
• Defined contribution retirement plans with employer match and other financial wellness programs.
• Educational Assistance Program.
• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training.
• Premium pay such as shift, on call, and more based on a teammate's job.
• Incentive pay for select positions.
• Opportunity for annual increases based on performance.