Senior Pharmacy Technician Call Center - Remote Work from Home in Arizona - Medicaid and Medicare Pharmacy Services
Join CVS Health: Transforming Healthcare with Heart At CVS Health, we're driven by a singular purpose: Bringing our heart to every moment of your health. As a leading healthcare company, we're committed to delivering personalized, convenient, and affordable care in a rapidly changing world. Our culture is built on empathy, innovation, and a passion for making a difference. We're seeking a highly skilled Senior Pharmacy Technician Call Center to join our team remotely from Arizona, playing a vital role in our Medicaid and Medicare pharmacy services. About CVS Health CVS Health is a trusted name in healthcare, with a rich history of innovation and customer-centricity. Our company is built on a foundation of integrity, respect, and a commitment to delivering exceptional care. We're dedicated to creating a culture of inclusivity, diversity, and opportunity, where every employee can thrive and make a meaningful impact. Job Summary As a Senior Pharmacy Technician Call Center , you'll be responsible for supporting comprehensive coordination of Medicaid and/or Medicare pharmacy services, including intake and processing of pharmacy authorization requests. You'll evaluate, authorize, and communicate decisions for pharmacy requests according to clinical guidelines, ensuring that our members receive the care they need. This is a sedentary role involving significant periods of sitting, talking, hearing, and keying. Key Responsibilities Medicaid and Medicare Pharmacy Services: Support comprehensive coordination of pharmacy services, including intake and processing of pharmacy authorization requests. Quality Effectiveness: Promote and support quality effectiveness of healthcare and Pharmacy Services. Clinical Decision-Making: Evaluate, authorize approval, and communicate decisions for pharmacy requests according to clinical guidelines. Medication Management: Determine appropriateness for medications and communicate decisions to physicians, physician's office staff, medical management staff, members, and/or pharmacists. Clinical Research: Perform clinical research to support requests. Non-Medical Research: Perform non-medical research, including eligibility verification, COB, and benefits verification. Documentation: Maintain accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements. Compliance: Process requests in compliance with various laws and CMS regulations and company policies and procedures. Communication: Communicate with Aetna Case Managers, Health Plan Staff, External Pharmacies, and Health Care Providers. Escalation: Escalate requests to Pharmacist when request requires extensive clinical review or denial. Requirements Essential Qualifications National Pharmacy Technician Certification: Current and in good standing. Arizona State License: Current and in good standing. Proficiency in Computerized Pharmacy Systems: Experience with software applications. Excellent Communication Skills: Verbal and written communication skills. Windows-Based Software Applications: Experience with Windows-based software applications. Proprietary Systems: Utilize various proprietary systems to build, research, process, and enter requests. Confidentiality: Protect the confidentiality of member information and adhere to company policies regarding confidentiality. Preferred Qualifications High-Volume Call Center Experience: Experience in a high-volume call center and production unit. Retail, Hospital, Facility, or Call Center Experience: Experience in retail, hospital, facility, or call center. Education High School Diploma or G.E.D.: Required. Compensation and Benefits We offer a competitive salary and a comprehensive benefits package, including: Pay Range: $18.50 - $31.72 per hour. Medical, Dental, and Vision Benefits: A full range of medical, dental, and vision benefits. 401(k) Retirement Savings Plan: Eligible employees may enroll in the Company's 401(k) retirement savings plan. Employee Stock Purchase Plan: Available for eligible employees. Fully-Paid Term Life Insurance Plan: Provided to eligible employees. Short-Term and Long-Term Disability Benefits: Available to eligible employees. Well-Being Programs: Numerous well-being programs. Education Assistance: Available. Free Development Courses: Available. CVS Store Discount: Available. Discount Programs: With participating partners. Paid Time Off (PTO): Or vacation pay. Paid Holidays: Throughout the calendar year. Why Join CVS Health? At CVS Health, we're committed to creating a culture of opportunity, inclusivity, and diversity. As a Senior Pharmacy Technician Call Center , you'll have the chance to: Make a Difference: In the lives of our members and the communities we serve. Grow and Develop: Your skills and career. Work with a Purpose: Driven by a clear purpose and values. Enjoy a Comprehensive Benefits Package: And rewards. How to Apply If you're ready to join a team that's passionate about transforming healthcare, apply now! We look forward to discussing how you can become a vital part of our success story. Apply Now Don't miss this opportunity to bring your heart to CVS Health! Apply for this job