Pharmacy Technician
Pharmacy Technician
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USD 55000 - 65000
1 Vacancy
Job Description
COMPANY OVERVIEW
Zing Health is a tech-enabled insurance company making Medicare Advantage the best it can be for those 65-and-over. Zing Health has a community-based approach that recognizes the importance of the social determinants of health in keeping individuals and communities healthy. Zing Health aims to return the physician and the member to the center of the health care equation. Members receive individualized assistance to make their transition to Zing Health as easy as possible. Zing Health offers members the ability to personalize their plans access to facilities designed to help them better meet their healthcare needs and a dedicated care team. For more information on Zing Health visit .
Summary Description
Zing Pharmacy Services staff work to ensure that Zing Health members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective safe manner. The Zing Health Pharmacy Technician is responsible for supporting the development maintenance and ongoing oversight for clinical and operational pharmacy programs and processes at Zing Health.
Essential Functions
Formulary Management
- Responsible for all administrative components of formulary creation development and maintenance.
- Non-clinical subject matter expert (SME) of formularies.
- Create maintain submit and post formularies using formulary management tool for all lines of business.
- Partner with key stakeholders to provide oversight and monitoring of formulary marketing materials claims adjudication testing and participation in weekly PBM calls.
- Support pharmacy operations team in the analysis of monthly and yearly formulary submissions.
- Conduct scheduled and ad hoc comparisons of competitor drug coverage for all lines of business.
Quality Assurance & Regulatory
Assists Zing Health customer services network pharmacies and health plan providers in resolving member prescription claims prior authorization appeals or pharmacy services access issues.
- Participate and provide support for internal and government audits.
- Participate in internal work groups as required (e.g. FWA Member Services)
- Develop and maintain pharmacy operations workflows job aids and training materials as required.
- Support resolution of member grievances as needed.
- Act as pharmacy operations liaison with internal Zing departments as designated.
- Develop materials and educate internal departments on pharmacy operations as deemed necessary.
- Participates in the development/administration of programs designed to enhance the utilization of targeted therapeutic drug classification enhancing Part D STARS outcomes.
- Completes assignments for special projects which may include compiling information report generation and maintenance of necessary records and files.
- Follows directions of Pharmacy Leadership related to day-to-day operations and evolving program management.
- Track and formally respond to pharmacy related inquiries from internal and external stakeholders.
- Proficient at researching and resolving medication issues using the appropriate reference material until complete issue resolution.
QUALIFICATIONS AND REQUIREMENTS:
JOB REQUIREMENTS:
Required Qualifications:
- 2 years experience as a Pharmacy Technician
Education:
- High School Diploma or GED equivalent
Preferred Education
- Associates Degree
- Minimum of 2 years of experience in health care or health insurance industry preferred.
- Experience in retail hospital or managed care pharmacy industry required.
- Experience working with Medicare Parts B and D and/or Medicaid Plans preferred.
Certifications/Licenses:
Required License
- Active Certified Pharmacy Technician (CPh.T) license.
Required Skills:
- Must exhibit an intermediate level of expertise in the following:
- Working knowledge of pharmaceutical managed care and PBM industries
- Uses pharmacy claim reports to perform audits and quality checks on prior authorizations that are active in the pharmacy claims processor.
- Working knowledge of pharmaceutical claims language drug usage and generic substitution practices.
- Computer skills and working knowledge of Microsoft products claims processing software and report generation.
- Ability to learn new software applications.
- Familiarity with Formulary Lists including common edits and restrictions.
Additional Required Skills:
- Experience with CVS as a Pharmacy Benefit Manager (PBM)
- Strong knowledge of healthcare delivery
- Excellent Communication skills Listening speaking and writing.
- Personal management skills Plan and manage multiple assignments and tasks set priorities and adapt to changing conditions and work assignments.
- Teamwork the ability to work well with one or more groups.
- Interpersonal effectiveness Relate to co-workers and build relationships with others in the organization.
- Strong work values Dependability honesty and a positive attitude.
Zing Health offers the following benefits:
- A competitive salary based on the market
- Medical Dental and Vision
- Employer-Paid Life Insurance
- 401(K) match up to 4%
- Paid-Time-Off
- Several supplemental benefits are available including but not limited to Spouse Insurance Pet Insurance Critical Illness coverage ID Protection etc.
Required Experience:
IC
Employment Type
Full-Time
