Temporary- Managed Care Pharmacy Technician

Grounded by a compelling mission, core values, and compassion for people, CDPHP and its family of companies offer a strong foundation for a rewarding career. Established in 1984, CDPHP is a physician-founded, member-focused, and community-based not-for-profit health plan that offers high-quality affordable health insurance to members throughout New York. The company values people, quality, innovation, and community, and its corporate culture supports those values wholeheartedly. CDPHP is committed to fostering a culture of belonging and takes a wholistic approach to diversity, equity, and inclusion. At CDPHP, the employees have a voice and are encouraged to make an impact at both the company and community levels through engagement and volunteer opportunities. CDPHP invests in employees who share these values and invites you to be a part of that experience.

Under the direct supervision of a licensed pharmacist, the Managed Care Pharmacy Technician (Pharmacy Tech) is responsible for administering CDPHP member and client-specific programs aimed at optimizing pharmacy benefits and the prescription process. This position will handle live calls to members as well as physicians and pharmacists, to provide information regarding pharmacy benefits, formulary coverage and CDPHP initiatives. The pharmacy tech will support initiatives including prior authorization work under the guidance of a licensed pharmacist. The pharmacy tech is responsible for implementing and monitoring the technical aspects of pharmacy benefits including the processing of medical exception requests using approved clinical algorithms, advising on pharmacy matters from internal and external sources, as well as additional ad hoc project work which supports the pharmacy department. The pharmacy tech will participate in an on-call/holiday rotation along with a utilization management pharmacist to support Plan members in after hour pharmacy issues.

Qualifications:

• Certification as Pharmacy Technician (CPT) through the Pharmacy Technician Certification Board, or completion of CPT accredited program required. An additional two (2) years of relevant pharmacy experience may be substituted for this credential.
• If CPT designation has been previously obtained but not been renewed, recertification and updated continuing education completion must be completed within 90 days of employment.
• Minimum three (3) years of experience in a retail pharmacy or managed care pharmacy setting required, or minimum five (5) years of experience without a CPT or completion of CPT accredited program.
• Experience with pharmacy claims processing, PBM systems, pharmacy billing and payment required.
• Experience in pharmacy policy, procedures, pharmacy payment systems, pharmacy market references and pricing methods including therapeutic category knowledge required.
• Experience with Microsoft Office, including Word, Excel, Outlook and PowerPoint is required.
• Demonstrated knowledge of pharmaceuticals, therapeutic category, routes of administration, delivery systems.
• Demonstrated ability to work with system support customers as well as interfacing with IT personnel to solve problems.
• Demonstrated ability to pro-actively identify problems, as well as recommend and/or implement effective solutions.
• Must be detail-oriented with strong organizational skills, including the ability to coordinate workflow.
• Excellent verbal and written communication skills.
• Flexibility to adapt to a changing and fast-paced environment.
• Demonstrated ability to work with and maintain confidential information.
• Demonstrated ability to provide excellent customer service and develop relationships both internally and externally.
• Ability to cover rotating on-call responsibilities, as well as a late shift on Fridays.
• Ability to work additional hours as needed in order to meet turnaround time responsibilities.

As an Equal Opportunity / Affirmative Action Employer, CDPHP will not discriminate in its employment practices on the basis of race, color, creed, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, protected veterans status, or any other characteristics protected under applicable law. To that end, all qualified applicants will receive consideration for employment without regard to any such protected status.

CDPHP and its family of companies include subsidiaries Strategic Solutions Management Consultants (SSMC), Practice Support Services (PSS), and ConnectRx Services, LLC.