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ATTENTION JOB SEEKERS AND MOLINA APPLICANTS: FRAUD ALERT

Be aware that third parties posing as Molina Healthcare may be soliciting money from job seekers and extending offers to candidates who have not interviewed. Molina does not engage in these type of practices. If you have received an offer and have not been engaging with Molina Healthcare in an interview process, reach out to erc@molinahealthcare.com to validate the legitimacy of your offer. Please note that Molina has reported this activity to the appropriate law enforcement agencies for further investigation. If you feel you’ve been victimized, please report it to local law enforcement.

Pharmacy Tech UM Remote - PST Hours -State & Ntl Cert

Molina Healthcare Arizona; Bowling Green, Kentucky; Covington, Kentucky; Detroit, Michigan; Grand Rapids, Michigan; Omaha, Nebraska; Rio Rancho, New Mexico; Milwaukee, Wisconsin; Warren, Michigan; Yonkers, New York; Columbus, Ohio; Cleveland, Ohio; Las Cruces, New Mexico; Santa Fe, New Mexico; Austin, Texas; Kentucky; New York; Wisconsin; Phoenix, Arizona; Chandler, Arizona; Scottsdale, Arizona; Orlando, Florida; St. Petersburg, Florida; Roswell, New Mexico; Sterling Heights, Michigan; West Valley City, Utah Job ID 2029224
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Molina Healthcare is hiring for a Pharmacy Technician who is BOTH State Licensed/Certified and Nationally certified.
This role is 100% remote, and the hours will be Mon-Fri 11am to 730pm Central Standard Time

  • This role will be working in the UM Pharmacy reviewing incoming Prior Auth requests for Medicaid and Marketplace members through both the medical and pharmacy benefit.  There will be coordination with pharmacists to make determinations on cases.

Highly qualified candidates for this role will have the following experience-

  • Positive “Can Do” attitude
  • Specialty Pharmacy (any) and Retail Pharmacy (at least 3 years) experience are ideal
  • Must be computer savvy- able to work within several computer systems at once, MS Note experience a plus
  • Managed care experience 
  • High level of communication skills, both written and verbal
  • Able to utilize resources to work independently

Molina Pharmacy Services/Management staff work to ensure that Molina members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal and state laws. Jobs in this family include those involved in formulary management (such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services (such as, therapeutic drug monitoring, drug regimen review, patient education, and medical staff interaction), and oversight (establishing and measuring performance metrics regarding patient outcomes, medications safety and medication use policies).

KNOWLEDGE/SKILLS/ABILITIES

  • Performs initial receipt and review of non-formulary or prior authorization requests against plan approved criteria. Requests additional information from providers as needed to properly evaluate the request.
  • Accurately enters on-line approvals or denials of requests. Authorized to make and carry out simple prior authorization requests within established policies and procedures.
  • Participates in the development /administration of programs designed to enhance the utilization of targeted drugs and the identification of cost saving pharmacy practices.
  • Identifies and reports departmental operational issues and resource needs to appropriate management.
  • Assists Molina Member Services, pharmacies, and health plan providers in resolving member prescription claim, prior authorization, or pharmacy services access issues.
  • Articulates Pharmacy Management policies and procedures to pharmacy/health plan providers, other Molina staff and others as needed.

JOB QUALIFICATIONS

Required Education: High School Diploma or GED equivalent
Preferred Education: Associate degree

Required Experience: 2 years’ experience as a Pharmacy Technician
Preferred Experience: 3+ years

Required License, Certification, Association: Active and unrestricted Pharmacy Technician Certification

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Key Words: Pharmacy Technician, Pharm Tech, Tech, National Certification, State License, Certification, Claims, Pharmacy Claims, Pharmacy, PBM, National Certified Pharmacy Technician (CPhT) certification, Medicaid, Medicare, Managed Care, MCO, Exchange, PBM, Pharmacy Benefit Management, Prior Auth

Same Posting Description for Internal and External Candidates

Pay Range: $20.29 - $31.71 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

About Us

Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Job Type: Full Time Posting Date: 12/17/2024

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