Aetna Veterans Jobs

Job Information

Aetna Senior Pharmacy Technician-Call Center in Phoenix, Arizona

Req ID: 60465BR

Job Description

Evaluates, authorizes approval, and communicates decisions for prior authorization pharmacy requests according to clinical guidelines.

Fundamental Components included but are not limited to:

  • Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.

  • Determines appropriateness for medications.

  • Communicates decision to physicians, physician s office staff, medical management staff, and/or pharmacists. Communicates selected prior authorization criteria, pharmacy benefit coverage, and formulary alternatives to physicians, physician s office staff, medical management staff, and/or pharmacists.

  • Researches, resolves, and documents prior authorization outcomes in the pharmacy system.

  • Escalates requests to Pharmacist when request requires extensive clinical review or denial. Researches, resolves, and documents physician or client inquiries and grievances.

  • Provides verbal or written results to client, prescriber, provider, and/or management.

  • Monitors telephone system to ensure adequate staffing to maintain client service levels. Assesses training needs within the team.

  • Serves as a training resource, mentor, and coach to others, particularly new hires. Identifies and shares best practices. Demonstrates, advocates, and reinforces a positive team environment, professionalism, and the need to present a positive image of the company when interacting with customers. Performs other duties as required.

Qualifications Requirements and Preferences:

  • Pharmacy Technician Certification or License

  • Excellent verbal and written communication skills.

  • Experience with Windows-based software applications.

  • 2 years experience in retail, hospital, or facility pharmacy required.

  • Ability to follow clinical criteria and instructions

  • Proficiency in computerized pharmacy systems and software applications required.

  • High School Diploma or equivalent.

Additional Job Information:

Required Licenses and Certifications

Pharmacy Technician

Functional Experience

Functional - Clinical /

Medical - Pre-certification/1-3 Years

Functional - Customer

Service - Customer Service - Pharmacy/1-3 Years

Technology Experience

Technical - Computer

Operations - System and Console Operations/1-3 Years/

Benefit Eligibility

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Job Function: Health Care

Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.