Pharmacy Technician - Prior Authorization Specialist II or III

About Us:

Arizona Liver Health (ALH) is dedicated to driving high standards of care and advancing medical innovation through leading clinical trials, ensuring patient safety and regulatory compliance, and generating high-quality clinical data. Our network of multiphase, multitherapeutic research, standard of care, and VEN Centers sites is staffed by skilled providers, research, clinic, pharmacy, and patient outreach professionals. ALH operates state-of-the-art facilities and programs to meet the evolving needs of clinical research and overall patient treatment.

Job Summary:

The Pharmacy Technician - Prior Authorization Specialist II or III is a crucial part of the healthcare team to assist patients in providing specialized, complex medications for their liver disease and/or condition. This includes obtaining authorizations, navigating financial assistance options, and working with patients, payors, and pharmacies. The prior authorization specialist takes care of the prescription from the time it is ordered to ensuring the patient receives the medication(s).

Location: Onsite in Mesa, AZ

Schedule: Full-Time, 8am-5pm, Monday-Friday

Compensation : $23 - $32 per hour, depending on experience and qualifications

Essential job functions/duties

Reasonable accommodation may be made to enable individuals with disabilities to perform these essential functions.

Assure all prior authorizations (PA) requirements are complete.

Facilitate labs/immunization completion for patient payor compliance.

Interact professionally with patients, peers, and other outside vendors as required.

Assists in training new pharmacy staff along with level III PA Specialists on organizational processes and compliance procedures

Manage pharmacy software for patient compliance with treatment.

Supports comprehensive coordination of commercial, Medicaid and/or Medicare pharmacy services including intake and processing of pharmacy authorization requests.

Promotes and supports quality effectiveness of healthcare and Pharmacy Services within clinical setting

Evaluates, aids in authorizing approval, and communicates decisions for pharmacy requests according to clinic process

Evaluates and aids in authorizing approval of pharmacy requests received by telephone, facsimile, and/or other means using client clinical criteria

Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements with minimal supervision

Process requests in compliance with various laws and CMS regulations and company policies and procedures

May communicate with payors, external pharmacies, patients, case managers, electronic PA platforms

Promotes communication, both internally and externally, to enhance effectiveness of medication therapy management services

Escalates requests to Nurse Case Manager when request requires extensive clinical review or denial

Knowledge/Skills/Abilities Required

At least one to two (1-2) years of experience working in Pharmacy Prior Authorizations required

Previous lead-tech experience highly preferred

Prior experience and working knowledge with pharmacy operations

Prior experience assisting in preparing detailed policy and procedures for accrediting agencies preferred

Ability to work independently with minimal day-to-day supervision

Excellent written, verbal, and interpersonal/patient-service communication skills required

Proficient in Microsoft Office including Outlook and Excel

Intermediate-level data entry computer skills with high attention to detail

Bilingual (English/Spanish) preferred

Ability to multi-task between different platforms, programs

EMR or pharmacy software proficiency required

Good working level knowledge of pharmacy insurance benefits required

Education, credentials, and/or trainings required:

High school diploma or GED from an accredited institution required

Associate or bachelor’s degree in pharmaceutical or healthcare related field preferred

CPhT Certification (PTCB or NHA) and Arizona License in good standing preferred.

Complete Apexus 340B on-line Modules upon hire

Experience with all aspects of the day- to -day pharmacy operations

Prior pharmacy benefits experience required.

Supervisory responsibilities

None

Work environment

Office / Clinic setting

Physical demands

Able to lift at least 15 lbs.

Able to sit for long periods (at least 50%)

Able to type and do computer work for long periods.

Travel Requirements

Some interoffice travel may be required with use of company vehicle or mileage reimbursement.

Benefits & Perks:

Health, Dental, Vision (with HSA plans and employer contribution)

2 weeks PTO

Continuing Medical Education budget (CME) and time off

5 days Sick Time

7 Company holidays and 2 half-days

401K with company match

Short & Long Term Disability

Shared company vehicles for required travel

Work authorization

Must have valid documentation and authorization to work in the U.S.

EEO statement

It is the policy of the Institute for Liver Health DBA Arizona Liver Health and Arizona Clinical Trials to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information or any other protected characteristic under applicable law. This policy relates to all phases of employment, including, but not limited to, recruiting, employment, placement, promotion, transfer, demotion, reduction of workforce and termination, rates of pay or other forms of compensation, selection for training, the use of all facilities, and participation in all company-sponsored employee activities. Provisions in applicable laws providing for bona fide occupational qualifications, business necessity or age limitations will be adhered to by the company where appropriate.

Other duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Other responsibilities may be communicated directly by the reporting manager/supervisor. Duties, responsibilities, and activities may change. Company reserves the right to adjust role scope with or without notice.

Notice to Staffing Agencies: It is our policy that any and all contact with third party staffing or recruitment vendors come through our Talent Acquisition Team directly. We have an established and preferred network of contracted partners that we engage if and when we deem it necessary. We request that staffing agencies refrain from repeatedly contacting our hiring managers or employees directly. Unsolicited resumes, onsite solicitations, and inquiries will not be considered or responded to. Overly persistent or pushy inquires may also be blocked across our network as spam. Thank you for your understanding and cooperation.