Job Title: Certified Pharmacy Technician
Duration: 6 months Temp to hire
Pay Rate: $23.00/hr - $31.05/hr
Shift Timing (Day/ Evening/ Night) : Monday to Friday
Job Description:
- Seeking a highly motivated Pharmacy Services Specialist to join our team. Under general supervision, the Pharmacy Services Specialist will be responsible for assisting participating pharmacies, CalOptima Health members, providers, internal departments, health networks and other entities in assuring the efficient, timely and effective provision of pharmaceutical products and services to members. The incumbent will serve as a point of contact by calling and following up with members, individual pharmacies, member advocates, family members, health networks, regional center and other agencies.
Role & Responsibilities:
- Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
- Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
- Handles specified caseloads to ensure cases are resolved within departmental standards and maintains documentation of member and pharmacy cases.
- Retrieves drug-specific technical data and information necessary to complete departmental and interdepartmental pharmacy-related functions and operations.
- Assists network pharmacies and prescribers with the resolution of pharmacy-related issues such as billing, claims processing, eligibility or pharmacy authorization requests.
- Resolves claims disputes between network pharmacies, pharmacy claims administrator, CalOptima Health's Claims department and other entities as necessary.
- Interprets and articulates Pharmacy Management program policies and procedures to pharmacy providers, other providers, CalOptima Health staff, external agencies and others as needed.
- Assists in processing pharmaceutical prior authorization and appeals requests per the CalOptima Health prior authorization guidelines.
- Establishes and maintains key contacts internally and externally to assure appropriate coordination and provision of pharmacy services to CalOptima Health members.
- Processes referrals from and works in conjunction with the Customer Service department to resolve all pharmacy-related member complaints and prior authorization requests.
Minimum Qualifications:
- High school diploma or equivalent PLUS 1 year of experience as a Pharmacy Technician in the ambulatory, community, home infusion, long-term care or managed care setting required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
Preferred Qualifications:
- Associate's degree in a health-related field.
- Pharmacy Technician Certification Board (PTCB) credentials.
- Bilingual in English and in one of CalOptima Health's defined threshold languages (Arabic, Chinese, Farsi, Korean, Russian, Spanish, Vietnamese).
Required Licensure / Certifications:
- Completion of an accredited Pharmacy Technician training program and possession of a registration certificate as a Pharmacy Technician from the California Board of Pharmacy required.
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22nd Century Technologies, Inc.
Pay Rate: $23.00/hr - $31.05/h
Aug 05, 2025