Pharmacy Technician, Specialty

Summary

Join Rightway's PBM Clinical Operations team as a Specialty Pharmacy Technician / Specialty Pharmacy Guide (CPhT) and play a key role in supporting Specialty Clinical Pharmacists. You will engage with specialty members, providing empathetic support and resolving inquiries via various communication channels. Responsibilities include managing prior authorizations, coordinating medication fulfillment, and addressing member questions regarding benefits and costs. You will also assist with patient outreaches, administrative tasks, and quality reviews. This role requires a CPhT certification and 1-2 years of experience in a specialty pharmacy setting. Excellent communication and problem-solving skills are essential.

Requirements

• 1-2 year’s experience in a pharmacy technician role within a Specialty pharmacy, PBM, pharmacy department of a health plan, or similar managed care setting
• Active Certified Pharmacy Technician (CPhT)
• Detail-oriented, adaptable, critical thinker, empathetic, ability to dig deep in understanding an issue to get to true root cause and resolution, desire to improve a patient’s healthcare experience and provide concierge level service
• Knowledge of pharmacy claims adjudication and benefit designs/terminology, ability to multi-task and prioritize work, ability to work independently

Responsibilities

• Serves as direct member and provider contact for specialty pharmacy benefit information, prior authorization requests, and navigation support. Inquiries may be received by telephone, chat, fax, email, or written correspondence
• Prior to the receipt of medication, provides support to members enrolled in specialty management programs, including coordinating any needed prior authorization with the UM team, the fulfillment of the prescription with the specialty pharmacy partner, enrollment in patient assistance programs, and billing questions. After receipt of medication, follow up with members to ensure satisfaction, connect member with a pharmacist for any clinical questions, and coordinate future refills
• Fields questions from members, human resources departments, pharmacies, and providers related to specialty distribution, benefit design, formulary coverage and cost of medication, prior authorization criteria, claims adjudication, copay/patient assistance, and ensures individual’s questions and issues are resolved
• Supports Specialty Clinical Pharmacists in patient and provider outreaches, including scheduling of appointments between members and pharmacists, enrollment of members into copay or patient assistance programs, medication adherence support, and other administrative tasks
• Assists in ensuring all operating and productivity standards are met, which may include conducting quality reviews of calls, chats, and documentation notes to identify opportunities for improvement
• Ensures regulatory and privacy standards are consistently met
• Provide support to other teams within Clinical Operations, such as utilization management and navigation

Preferred Qualifications

• Associate’s or Bachelor’s degree preferred
• Bi-lingual preferred (Spanish)

Benefits

BASE SALARY: $22-23/hr