Pharmacy Technician – Health Plan Operations

Requisition #20166
Employment Type

Full-time

Experience

2+ years of Pharmacy related experience and training; or equivalent combination of education and experience.

Required Degree

Associates Degree

Location

445 Grant Avenue, San Francisco, CA 94108

Region
Bay Area San Francisco
Application Email
Apply Now

Brief job information:

The pharmacy technician provides assistance for the Manager, Pharmacy Services and other pharmacy staff with various projects within the health plan to maintain compliance with CMS (Centers for Medicare and Medicaid Services) and DMHC (Department of Managed Healthcare) standards. The technician will also perform routine administrative tasks as directed by the Manager, triage pharmacy claims issues from Chinese Hospital pharmacies, coordinate meetings and projects, present to internal staff, and provide outreach to various entities (enrollees, physicians, third party vendors, etc).

ESSENTIAL DUTIES AND RESPONSIBILITIES

  1. The pharmacy technician position is responsible for various responsibilities that include, but are not limited to, the following tasks:
  2. Provide assistance with eligibility and claims troubleshooting for Chinese Hospital Pharmacy staff and Member Services.
  3. Compose, review, and modify outreach notifications to members, physicians, and management team within the health plan in accordance with regulatory bodies.
  4. Facilitate communication and collaboration between internal departments and Pharmacy for all relevant prescription benefit projects.
  5. Compare prescription claim data to report discrepancies and trends to the Pharmacy Services Manager or PBM (Pharmacy Benefits Manager).
  6. Review CMS and DMHC notifications and generate the monitoring reports to ensure the health plan is compliant and up-to-date with the regulations enforced by local, state, and federal entities.
  7. Participate in, evaluate, and maintain efficient workflow procedures in accordance with the clinical programs and the Pharmacy Department’s goals and objectives.
  8. Support with the MTM (Medication Therapy Management) Program, including but not limited to, scheduling MTM appointments, opting-out members, translating patient takeaways, and mailing. Provide outreach calls to members, providers, and other pharmacies as needed.
  9. Accept and perform other duties as assigned.

QUALIFICATIONS

  • Excellent communication skills, both orally and in writing, including presentation experience
  • Ability to work independently with minimal supervision
  • High level of attention to detail
  • Proficiency with Microsoft Office programs (Outlook, Excel, Word, etc.) –Advanced skills preferred.
  • Firm understanding of drug benefits, formulary, and claims processing
  • Authorization to work in the United States
  • Available to work 40 hours per week and overtime as required according to the needs of the business
  • Valid and up-to-date Pharmacy Technician license in the State of California
  • AA Degree and 2+ years of Pharmacy related experience and training; or equivalent combination of education and experience.
  • Chinese Speaking Preferred, but not required
  • All positions require a pre-employment background investigation and drug screen.

In our efforts to control the spread of COVID-19 and its variants, CCHP requires that its employees be fully vaccinated as of their start date. If you require a medical or religious accommodation we will engage in the interactive process with you. Proof of vaccination will be required prior to start. If we make you an offer and you are not yet vaccinated, we will accommodate a delay in start date. CCHP may also mandate that its employees receive vaccine boosters, and all accommodation laws will be followed.