Corewell Health
Pharmacy Technician MCC Prior Authorization and Infusion
Corewell Health, Grand Rapids, Michigan, us, 49528
Medication Care Coordinator
The Medication Care Coordination Team (MCC) is a centralized team that works closely with six departments to help obtain prior authorizations for high-cost medications, quantity limits, tier exceptions, and non-formulary medications that are ordered by providers. The MCC team covers multiple provider offices and specialties and collaborates with insurance companies, pharmacies, and Corewell Health clinics to obtain the necessary information for completing a prior authorization and ensuring accurate prescription processing at the destination pharmacy. This position is a supportive role for the systems ambulatory clinics. The tasks for this position will include, but are not limited to, completing pre and/or prior authorizations, assisting with patient assistance programs, scheduling patients from provider referrals or other registries, working with insurance companies to review coverages, communicating with patients and clinical staff, and managing parts of the medication use cycle. There will be additional opportunities to think innovatively and collaborate on projects with other departments and within our own department. Pull, transcribe, and organize clinical information from patient charts into third party platforms or navigators. Complete authorization requests in a timely and efficient manner without compromising quality, to ensure patients receive their care as scheduled. Identify and schedule appointments for pharmacists from provider referrals, quality reports, and other available registries. Demonstrate the ability to utilize all payer websites to assist verifying patient's coordination of benefits and authorization requirements. Assist with inventory and medication use cycle tasks if in clinic. Organize and track data for multiple payer programs and service lines. Communicate positively and effectively with patients, colleagues, and clinic staff. Adhere to all department procedures, guidelines, and standard work with the ability to utilize resources appropriately. Qualifications: Required High School Diploma or equivalent Preferred Associate's Degree 1 year of relevant experience Retail or Ambulatory Pharmacy Experience Preferred 1 year of relevant experience Prior Authorization Experience or Insurance Navigation Preferred 1 year of relevant experience Epic Experience Preferred LIC-Pharmacist Intern - STATE_MI State of Michigan Upon Hire required Or LIC-Pharmacy Technician Temp - STATE_MI State of Michigan Upon Hire required And LIC-Pharmacy Technician - STATE_MI State of Michigan 90 Days required CRT-Pharmacist Technician, Certified (CPHT) - PTCB Pharmacy Technician Certification Board Excludes - LIC - Pharmacist Intern 90 Days required Or CRT-Exam for the Certification of Pharmacy Technicians (ExCPT) - NHA National Healthcareer Association Excludes - LIC - Pharmacist Intern 90 Days required Ideal candidate will possess both Full Pharmacy Technician License and National Certification, such as CPhT from PTCB and ExCPT from NHA Ideal candidate will also possess 1+ years of Retail Pharmacy experience and preferably 1+ years of Prior Authorization Experience or Insurance Navigation experience This position will require Strong Proficiency in Microsoft Applications, such as MS Word, Excel, Outlook, Teams, and OneNote Epic Proficiency would be a very strong Plus Hours of Work: 40 Days Worked: Monday to Friday
The Medication Care Coordination Team (MCC) is a centralized team that works closely with six departments to help obtain prior authorizations for high-cost medications, quantity limits, tier exceptions, and non-formulary medications that are ordered by providers. The MCC team covers multiple provider offices and specialties and collaborates with insurance companies, pharmacies, and Corewell Health clinics to obtain the necessary information for completing a prior authorization and ensuring accurate prescription processing at the destination pharmacy. This position is a supportive role for the systems ambulatory clinics. The tasks for this position will include, but are not limited to, completing pre and/or prior authorizations, assisting with patient assistance programs, scheduling patients from provider referrals or other registries, working with insurance companies to review coverages, communicating with patients and clinical staff, and managing parts of the medication use cycle. There will be additional opportunities to think innovatively and collaborate on projects with other departments and within our own department. Pull, transcribe, and organize clinical information from patient charts into third party platforms or navigators. Complete authorization requests in a timely and efficient manner without compromising quality, to ensure patients receive their care as scheduled. Identify and schedule appointments for pharmacists from provider referrals, quality reports, and other available registries. Demonstrate the ability to utilize all payer websites to assist verifying patient's coordination of benefits and authorization requirements. Assist with inventory and medication use cycle tasks if in clinic. Organize and track data for multiple payer programs and service lines. Communicate positively and effectively with patients, colleagues, and clinic staff. Adhere to all department procedures, guidelines, and standard work with the ability to utilize resources appropriately. Qualifications: Required High School Diploma or equivalent Preferred Associate's Degree 1 year of relevant experience Retail or Ambulatory Pharmacy Experience Preferred 1 year of relevant experience Prior Authorization Experience or Insurance Navigation Preferred 1 year of relevant experience Epic Experience Preferred LIC-Pharmacist Intern - STATE_MI State of Michigan Upon Hire required Or LIC-Pharmacy Technician Temp - STATE_MI State of Michigan Upon Hire required And LIC-Pharmacy Technician - STATE_MI State of Michigan 90 Days required CRT-Pharmacist Technician, Certified (CPHT) - PTCB Pharmacy Technician Certification Board Excludes - LIC - Pharmacist Intern 90 Days required Or CRT-Exam for the Certification of Pharmacy Technicians (ExCPT) - NHA National Healthcareer Association Excludes - LIC - Pharmacist Intern 90 Days required Ideal candidate will possess both Full Pharmacy Technician License and National Certification, such as CPhT from PTCB and ExCPT from NHA Ideal candidate will also possess 1+ years of Retail Pharmacy experience and preferably 1+ years of Prior Authorization Experience or Insurance Navigation experience This position will require Strong Proficiency in Microsoft Applications, such as MS Word, Excel, Outlook, Teams, and OneNote Epic Proficiency would be a very strong Plus Hours of Work: 40 Days Worked: Monday to Friday