Responsibilities:

• Under the general supervision of the Supervisor of Pharmacy Prior Authorization Technicians, the Pharmacy Services Technician I assists in the prior authorization process.

• Reviews and approves physician inquiries for pre-authorization and medical necessity requests based on established pharmacy guidelines and contract criteria.

• Supports Fraud and Abuse program system oversight by reviewing medication utilization records. Communicates any suspected fraud discovered.

• Recommends course of action for providers where patterns appears outside of guidelines and generally accepted pharmacy standards.

• Keeps abreast of industry trends and regulatory changes in the pharmacy industry and incorporates knowledge in the performance of job duties.

• Identifies problems in process/procedures or services and makes recommendations for improvements. Maintains a balance of productivity, quality

• timeliness of job accountabilities. Participates in department self-audit procedures for on-going evaluation of service.

• Maintains and updates internal databases. Enters application information, prior authorizations and other relevant data.

• Ensures database information and appended files are current and accessible to staff. Generates reports and other information requested on a scheduled/as needed basis.

• Creates and supports an environment which fosters teamwork, cooperation, respect and diversity. Establishes and maintains positive communication and professional demeanor with AMFC employees and clients at all times.

• Performs other related duties as assigned.

• Attends required training on an annual basis.

• High School Graduate or GED equivalent - Required

• Pharmacy Experience - 2 Years - Required

• Minimum 35 words per minute typing speed - Required

All your information will be kept confidential according to EEO guidelines.