About the position
Responsibilities
• Perform initial receipt and review of non-formulary or prior authorization requests against plan approved criteria.
• Request additional information from providers as needed to properly evaluate requests.
• Accurately enter online approvals or denials of requests.
• Make and carry out simple prior authorization requests within established policies and procedures.
• Participate in the development and administration of programs designed to enhance the utilization of targeted drugs and identify cost-saving pharmacy practices.
• Identify and report departmental operational issues and resource needs to appropriate management.
• Assist Molina Member Services, pharmacies, and health plan providers in resolving member prescription claim, prior authorization, or pharmacy services access issues.
• Articulate Pharmacy Management policies and procedures to pharmacy/health plan providers and other Molina staff.
Requirements
• High School Diploma or GED equivalent
• 2 years’ experience as a Pharmacy Technician
• Active and unrestricted Pharmacy Technician Certification
Nice-to-haves
• Associate degree
• 3+ years of experience as a Pharmacy Technician
Benefits
• Competitive benefits and compensation package
