Aetna Senior Pharmacy Technician-Call Center in Phoenix, Arizona
Req ID: 60465BR
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
Functional - Clinical /
Medical - Pre-certification/1-3 Years
Functional - Customer
Service - Customer Service - Pharmacy/1-3 Years
Technical - Computer
Operations - System and Console Operations/1-3 Years/
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.