Medication Prior Authorization Specialist I

Major Responsibilities:

• 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

Licensure, Registration, and/or Certification Required:

• 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)

Education Required:

• High school diploma or GED equivalent
• For technicians in NC with validating technician responsibilities- an Associate’s Degree in Pharmacy Technology is required

Experience Required:

• Typically requires 3 years of experience in health care, insurance industry, pharmacy, or medical background

Knowledge, Skills & Abilities Required:

• 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

Physical Requirements and Working Conditions:

• Must be able to sit, stand, walk, lift, bend, kneel, climb, twist, crawl and reach above shoulders. May require extended periods of sitting.
• Requires considerable walking, standing, pushing mobile cart of approximately 50 pounds and lifting 35 pounds of material.
• Must have functional vision, touch and hearing
• Must be able to speak and be understood by others to communicate effectively
• Utilizes appropriate personal protective equipment (PPE) to perform job duties and minimize exposure to hazardous agents, body fluids, and communicable diseases.
• May be exposed to chemical hazards
• May be exposed to chemical and hazardous waste as well as blood and body fluids and communicable disease.
• Frequent fine motor motion of hands and wrists to perform manipulative skills such as writing, typing, data entry into the computer, and preparation of medications, including use of syringes
• Takes necessary precautions to avoid inadvertent needle sticks, minor cuts or bruises. Exposed to various conditions throughout the workday such as walking on hard surfaces, climbing stairs and changes in temperature and humidity.
• Operates all equipment necessary to perform the job
• Flexibility to travel between pharmacy locations
• This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of physical requirements and working conditions

Preferred Job Requirements Preferred Education

• Associate or bachelor's degree

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties. Apply To This Job