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You will be updated with latest job alerts via email$ 18 - 29
1 Vacancy
Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. Were proud to offer many development and advancement opportunities to our nearly 50000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.
Work Shift:
8 Hours - Day Shifts (United States of America)Scheduled Weekly Hours:
40Salary Range: $18.00 - $29.00Union Position:
NoDepartment Details
Summary
Responsible for following policies and procedures set within the pharmacy department to ensure that Members obtain appropriate medications in a timely cost-effective and efficient manner. Requires use of and proficiency in multiple computer programs.Job Description
This job involves a significant amount of time on the telephone handling calls from Members pharmacies and providers concerning pharmacy issues such as coverage prior authorization step therapy networks and overrides and denial rationale. Review incoming prior authorization request and contact providers office pharmacies prior authorization department or Member (depending on where the request originates) to clarify the intent of the prior authorization and identify any potential missing information. Enter prior authorizations and formulary exception requests into referral form. Review Plan policy to determine which requests need to be sent on the clinical pharmacist team for review. Will complete initial and benefit denial letters. Serve as a liaison with the pharmacy benefit manager (PBM) in regards to pharmaceutical questions or issues that arise. Serve as a resource for other departments within the health and maintain all benchmark stats (prior authorizations medical claims reviews phone approval denial letters and CRM volume) while holding this position.Qualifications
Pharmacy technicians must have a minimum of a high school diploma or equivalent.Sanford is an EEO/AA Employer M/F/Disability/Vet.
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Required Experience:
IC
Full-Time