[Hiring] Pharmacy Technician, Retrospective Case Management @Navitus Health Solutions

Role Description

Archimedes is seeking a Pharmacy Technician, Retrospective Case Management to join our team! This position can be fully remote.

The Pharmacy Technician, Retrospective Case Management is responsible for managing their assigned work queue related to non-clinical work to support retrospective case management operations, benefit exclusions, formulary and therapeutic substitutions, and high-cost case management. This role will be able to successfully communicate with physicians, nurses, and pharmacists related to outstanding documentation needed for cases, patient medication history documentation, and drug cost information related to specialty and traditional medications.

The Pharmacy Technician, Retrospective Case Management will be divided into two areas:

• First review of retrospective case management of specialty medications against policies.
• High-cost case management support functions and internal clinical process development and maintenance activities.

In addition, this role will have the opportunity to help develop the expansion of services that can be performed by pharmacy technicians for support.

Qualifications

• High school diploma or GED required.
• Licensed Pharmacy Technician required.
• Pharmacy, Hospital, or Managed Care experience preferred.
• Benefit knowledge and experience preferred.
• Proficient in Microsoft Excel, Power Point, and Word required.
• Participate in, adhere to, and support compliance program objectives.
• The ability to consistently interact cooperatively and respectfully with other employees.

Requirements

• Develop and deliver follow up messages to physicians related to case management documentation.
• Organize peer-to-peer collaboration between physicians and pharmacists.
• Manage and act as a primary point of contact for high-cost case management and retroactive drug utilization cases, related to coordination of outbound physician notification and inbound case documentation.
• Manage queues and organize documents for pharmacy technician work that relates to case management.
• Perform retrospective case management related to provider denial and low-clinical acuity cases as identified by clinical policies and guidelines.
• Participate in, adhere to, and support compliance, people and culture, and learning programs.
• Perform other duties as assigned.

Benefits

• Top of the industry benefits for Health, Dental, and Vision insurance.
• 20 days paid time off.
• 4 weeks paid parental leave.
• 9 paid holidays.
• 401K company match of up to 5% - No vesting requirement.
• Adoption Assistance Program.
• Flexible Spending Account.
• Educational Assistance Plan and Professional Membership assistance.
• Referral Bonus Program – up to $750!