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Job ID: 10504
Location: Chapel Hill, NC
Facility/Division: Shared Services
Status: Full Time
Shift: Day Job
Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.
The Pharmacy Benefit Management Operations Technician will work with a team of pharmacists, technicians, and analysts to provide daily support regarding such items as formulary maintenance, prior authorization processing, and benefits documentation/communication.
Description of Job Responsibilities:
Develop and maintain drug lists and clinical edits associated with the formularies and utilization management strategies
Support the prior authorization program in all aspects including review of individual requests, communication of new and changing criteria, providing appropriate formulary alternatives, and working with physicians, patients and the claims adjudicator
Coordinate the process of entering formulary information from various sources such as the Pharmacy and Therapeutics Committee for adjudication and communicating changes to the appropriate outlets
Maintain up-to-date member and physician facing formulary documentation and make it available through the appropriate channels
Participate in and operationalize solutions to address inappropriate utilization, improve outcomes and optimize drug spend
Respond to and resolve pharmacy-related inquiries from members, clients, providers, or pharmacies related to formulary options, therapeutic alternatives, and Prior Authorization determinations for covered health plans. Appropriately triage inquiries to a pharmacist when clinical expertise is required
Effectively and accurately communicate with patients in a way that is compassionate and exemplifies the principles of Carolina Care
Provide project support and complete other projects/initiatives as assigned
Knowledge, Skills, and Abilities:
Excellent communication skills
Strong organizational and time management skills
Ability to work collaboratively and independently
Perform effectively in cross-functional groups
Self-initiative and self-motivated
● HS diploma or equivalent.
● Registration with the NC Board of Pharmacy unless enrolled in a PharmD program.
● CPhT from PTCB or ExCPT from NHA unless enrolled in a PharmD program.
Professional Experience Requirements:
● Two years of pharmacy technician experience required.
Legal Employer: NCHEALTH
Entity: Shared Services
Organization Unit: HCS Pharmacy Benefit Mgt
Work Type: Full Time
Standard Hours Per Week: 40.00
Work Schedule: Day Job
Location of Job: US:NC:Chapel Hill
Exempt From Overtime: Exempt: No
The UNC Health System and the UNC School of Medicine are committed to valuing all people throughout our organization, regardless of background, lifestyle, and culture. A diverse and inclusive work environment for staff and culturally appropriate care for our patients, are essential to fulfilling our UNC Health vision of improving the health of all North Carolinians.
UNC Health is an equal opportunity employer. As such, UNC Health offers equal employment opportunities to applicants and employees without regard to race, color, religion, sex, national origin, age, genetic information, disability, sexual orientation, gender identity or political affiliation.