Aetna Pharmacy Tech-Call Center in Sunrise, Florida

Req ID: 42886BR

POSITION SUMMARY

This position requires the Pharmacy Technician to review, deny or approve and communicate decisions for prior authorization pharmacy requests according to clinical guidelines.

Fundamental Components:

Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria. Determines the appropriateness for medications based on clinical guidelines. Communicates decisions to physicians, physician's office staff, medical management staff, and /or pharmacists. Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician's office staff, medical management staff and/or pharmacists. researches, resolves and documents prior authorization outcomes in the pharmacy system. Escalates requests to Pharmacist when request requires clinical review or denial. Researches, resolves and documents physician or client inquiries and grievances. Provides verbal or written results to client, prescriber, provider, and/or management.

BACKGROUND/EXPERIENCE desired:

6 months experience in retail, hospital, or facility pharmacy setting required.

Proficiency in computerized pharmacy systems and software applications required.

Excellent verbal and written communication skills.

Ability to follow clinical criteria and instructions

Experience with Windows-based software applications.

EDUCATION

The highest level of education desired for candidates in this position is a High School diploma, G.E.D. or equivalent experience.

LICENSES AND CERTIFICATIONS

Pharmacy/Pharmacy Technician is desired

Telework Specifications:

Candidate must be willing to work a flexible schedule with hours ranging from 8am-11pm est Monday- Friday 8am-5pm est Saturday and Sunday

ADDITIONAL JOB INFORMATION

Aetna is about more than doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. We care about each other, our customers and our communities. We are inspired to make a difference and we are committed to integrity and excellence. Together we will empower people to live healthier lives. Aetna is an equal opportunity and affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities. We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

Together we will empower people to live healthier lives.

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Job Function: Health Care