Pharmacy Prior Authorization Technician - Kelly Services : Job Details

The Pharmacy Prior Authorization Technician performs initial-level processing and review of prior authorization requests for both pharmacy and medical specialty drug reviews as permitted by law. Reviews are conducted in accordance with pharmacy management drug policies and procedures. Responsibilities include preparing and interpreting cases for Utilization Management (UM) reviews and acting as a content expert for applications used to process these requests. The Technician serves as a resource for staff on members contract benefits, related health plan functions, and provides leadership in the intake area of the prior authorization process. Essential Responsibilities/ Accountabilities Conduct initial medication prior-authorization, exception, and medical necessity reviews Route cases to pharmacist/medical director for final determination, as directed Issue verbal and written notifications to members as required Review and interpret prescription and medical benefit coverage (including...Authorization, Technician, Pharmacy Technician, Pharmacy, Medical Director, Claims Processor, Healthcare, Staffing