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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in pharmacy operations, including prescription interpretation, prior authorization processing, and compliance with Medicare requirements. Strong communication and problem-solving skills are essential for educating members and resolving inquiries effectively.
Highest-signal resume keywords
Pharmacy ExperienceState Pharmacy Tech CertificationPrior Authorization ProcessingCommunication SkillsAnalytical Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Prescription InterpretationData EntryAdjudication TroubleshootingReport GenerationRecord Maintenance
Soft Skills
Problem-Solving SkillsFacilitation SkillsInterpersonal Communication
Certifications & Qualifications
State Pharmacy Tech LicenseNational Pharmacy Tech Certification
Industry Keywords
Medicare ComplianceFormulary BenefitsRebatesBeers CriteriaGrievances and Appeals
About the role
Key responsibilities & impact- Interpret and enter basic prescriptions
- Process prior authorization requests from physician offices and ensure compliance with Medicare requirements
- Troubleshoot adjudication issues
- Verify member information and input data for pharmacists
- Educate members on pharmacy-based rules related to prescriptions and medication resources or assistance programs
- Inform relevant parties of prior authorization determinations
- Resolve grievances and appeals issues
- Respond to inquiries from physicians, sales team, and members regarding formulary and prescription benefits
- Generate reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports
- Maintain records of prior authorizations, rebates, and monthly reports
Requirements
What you’ll need- H.S. diploma or equivalent
- Minimum of 1 year of pharmacy experience
- Current State Pharmacy Tech Certification or National Certification based on applicable state(s) required
- Current State Pharmacy Tech License strongly preferred
- Strong oral, written and interpersonal communication skills
- Problem-solving skills
- Facilitation skills
- Analytical skills
- Ability to work full-time from the posted San Antonio location
- Ability to work an 8-hour shift from 8:00 am–5:00 pm CT, Monday to Friday
- Additional weekend and holiday hours may be necessary
- New candidates in certain patient/member-facing roles must become vaccinated against COVID-19 and Influenza, unless an acceptable explanation is provided
Benefits
Comp & perks- Merit increases
- Paid holidays
- Paid Time Off
- Incentive bonus programs
- Medical benefits
- Dental benefits
- Vision benefits
- Short-term disability benefits
- Long-term disability benefits
- 401(k) + match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources