Job Summary: The Pharmacy Technician II is responsible for data entry and review of submitted authorization requests, providing assistance to providers or pharmacies calling for assistance, and ensuring resolution for escalations received in the pharmacy department. Essential Functions: Review traditional and specialty medication prior authorization requests for the member’s pharmacy benefit submitted by providers Send fax communications to providers when necessary Contact provider offices to follow up on failed faxes Educate CareSource providers about resources outlining formulary alternatives Place prior authorizations for when approval is appropriate in the prior authorization system(s) Initiate process for routing prior authorizations requiring review by a pharmacist Answer calls from providers regarding prior authorization requests prescription coverage and formulary issues in a timely manner Perform outbound calls to obtain information from providers and/or pharmacies Document all telephonic interaction in appropriate system(s) Ensure all methods of inquiries (fax, e-mail, ePA) and submissions are answered with in the state mandated period Involvement in special projects reviewed by the management team when needed Answer calls and troubleshoot issues from retail and specialty pharmacies Assist Case Managers, Member and Provider Services with pharmacy issues, overrides, and questions Maintain awareness of current workload aging and respond with appropriate sense of urgency Maintain knowledge and understanding of all processes and procedures for all markets on faxes and phones Adhere to all departmental and company policies and procedures Perform any other job duties as requested Education and Experience: High School Diploma or equivalent years relevant work experience is required Three (3) years retail pharmacy or hospital pharmacy experience is preferred One (1) year managed care prior authorization experience is preferred Competencies, Knowledge and Skills: Computer proficient with knowledge in a “Windows” environment Beginners level Microsoft Word, Outlook, and Excel Must type 40 words per minute (WPM) Professional level telephone communication skills Familiarity with medical terminology Familiarity with medication names Excellent communication skills when speaking to providers offices, as well as pharmacies Ability to work independently and within a team environment Ability to train/teach new employees within the department Attention to detail Familiarity of the healthcare field Knowledge of Medicaid/Marketplace Critical listening and thinking skills Proper grammar usage Time management skills Proper phone etiquette Customer service oriented Decision making/problem solving Leadership experience and skills Licensure and Certification: Pharmacy Technician Certification is preferred Ability to acquire state registration in multiple states, as required Working Conditions: General office environment; may be required to sit or stand for extended periods of time Position requires the ability to work any shift between 7am and 9pm and the flexibility to work weekends and overtime, as needed Compensation Range: $35,200.00 - $56,200.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Hourly Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-JS1 The CareSource mission is known as our heartbeat. Just as we support our members to be the best version of themselves, our employees are driven by our mission to create a better world for members, stakeholders and providers. We are difference-makers who combine compassionate hearts with our unique business expertise to make every opportunity count. Each claim, each phone call, each consumer-centric decision is a chance to change the world for one member, and our employees look for ways to do that every day. The challenge is, there is no one right way to be the difference and we’re looking for people like you that will rewrite that definition every day. We do what it takes to form creative solutions that make our community and the world just a little better. Discover what it means to be #UniquelyCareSource.