Senior Pharmacy Technician - Call Center - Remote Work Opportunity with CVS Health - Medicaid, Medicare Pharmacy Services, and Quality Healthcare

Remote Full-time
Join the CVS Health Team as a Senior Pharmacy Technician in Our Call Center CVS Health is a leading healthcare company that is dedicated to delivering enhanced human-centric healthcare for a rapidly changing world. We are seeking a highly skilled and compassionate Senior Pharmacy Technician to join our call center team, working remotely to support comprehensive coordination of Medicaid and/or Medicare pharmacy services. As a Senior Pharmacy Technician with CVS Health, you will play a vital role in promoting quality effectiveness of healthcare and pharmacy services, evaluating and authorizing pharmacy requests, and communicating decisions to healthcare professionals and members. About CVS Health and Our Purpose At CVS Health, our purpose is to bring our heart to every moment of your health. We believe that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors support this purpose, empowering every employee to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make healthcare more personal, convenient, and affordable. Position Summary As a Senior Pharmacy Technician in our call center, you will be responsible for: Supporting comprehensive coordination of Medicaid and/or Medicare pharmacy services, including intake and processing of pharmacy authorization requests Promoting and supporting quality effectiveness of healthcare and pharmacy services Evaluating, authorizing approval, and communicating decisions for pharmacy requests according to clinical guidelines Evaluating and authorizing approval of pharmacy requests received by telephone, facsimile, and/or other means using client clinical criteria Determining appropriateness for medications and communicating decisions to physicians, physician's office staff, medical management staff, members, and/or pharmacists Performing clinical research to support requests Performing non-medical research, including eligibility verification, COB, and benefits verification Maintaining accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements Processing requests in compliance with various laws and CMS regulations and company policies and procedures Communicating with Aetna Case Managers, Health Plan Staff, External Pharmacies, and Health Care Providers Promoting communication, both internally and externally, to enhance effectiveness of medication therapy management services Escalating requests to Pharmacist when request requires extensive clinical review or denial Key Responsibilities As a Senior Pharmacy Technician in our call center, your key responsibilities will include: Clinical Responsibilities Evaluating and authorizing pharmacy requests according to clinical guidelines Determining appropriateness for medications and communicating decisions to healthcare professionals and members Performing clinical research to support requests Administrative Responsibilities Maintaining accurate and complete documentation of required information Processing requests in compliance with various laws and CMS regulations and company policies and procedures Communicating with healthcare professionals and members Requirements and Qualifications Essential Qualifications National Pharmacy Technician certification and Home State License, current and in good standing Proficiency in computerized pharmacy systems and software applications Excellent verbal and written communication skills Experience with Windows-based software applications Utilizes various proprietary systems to build, research, process, and enter requests Protects the confidentiality of member information and adheres to company policies regarding confidentiality Preferred Qualifications Experience in a high-volume call center and production unit Experience in retail, hospital, facility, or call center Education and Certification A high school diploma or G.E.D. is required for this position. Pay Range and Benefits The typical pay range for this role is $18.50 - $31.72 per hour. This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors, including experience, education, geography, and other relevant factors. This position is eligible for a CVS Health bonus, commission, or short-term incentive program in addition to the base pay range listed above. In addition to your compensation, CVS Health offers a comprehensive benefits package, including: Medical, dental, and vision benefits 401(k) retirement savings plan and Employee Stock Purchase Plan Fully-paid term life insurance plan Short-term and long-term disability benefits Numerous well-being programs and education assistance Free development courses and CVS store discount Paid Time Off (PTO) or vacation pay and paid holidays Work Environment and Culture As a remote worker, you will have the flexibility to work from home and enjoy a better work-life balance. Our company culture is built on our Heart At Work Behaviors, which empower every employee to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make healthcare more personal, convenient, and affordable. Career Growth Opportunities and Learning Benefits At CVS Health, we are committed to the growth and development of our employees. We offer numerous learning benefits, including free development courses and education assistance, to help you advance your career. As a Senior Pharmacy Technician, you will have opportunities to develop your clinical and administrative skills and take on new challenges. How to Apply If you are a motivated and compassionate pharmacy professional looking for a new challenge, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and cover letter, to be considered for this position. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws. Apply for this job
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