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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medication management, including prior authorization processing and adherence support, while ensuring compliance with Medicare and Medicaid regulations. Proficient in educating members on pharmacy resources and effectively addressing medication-related inquiries.
Highest-signal resume keywords
Pharmacy Technician CertificationPrior Authorization ProcessingMedication ReconciliationElectronic Health RecordsMedicare and Medicaid Compliance
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medication Data InputMedication AdherencePrior Authorization RequestsGrievance ResolutionCost Troubleshooting
Soft Skills
Patient CommunicationMultitaskingProblem Solving
Certifications & Qualifications
Active Professional LicenseState Pharmacy Technician CertificationNational Certification
Industry Keywords
Pharmacy ExperienceMedication ResourcesPatient EducationCompliance RequirementsCOVID-19 Vaccination
About the role
Key responsibilities & impact- Verify member information and input medication data
- Ensure medication access and adherence to optimize health
- Educate members on pharmacy-based prescription rules and medication resources or assistance programs
- Process prior authorization requests from physicians’ offices
- Ensure compliance with Medicare and Medicaid requirements
- Inform relevant parties of prior authorization determinations
- Provide resolution to grievances and appeals issues
- Respond to medication-related inquiries from patients, providers, and team members
- Receive calls from members to address medication or pharmacy-related needs
- Assist with medication adherence, prior authorization processing, medication reconciliation, and troubleshooting cost and medication access issues
Requirements
What you’ll need- Active professional license, if required by state law
- State Pharmacy Technician Certification or National Certification based on applicable state(s) requirements
- H.S. diploma or equivalent
- Minimum of 2 years of pharmacy experience
- Any combination of education and experience providing an equivalent background
- Experience working with electronic health records
- Basic knowledge of Medicare and Medicaid
- Experience talking with members/patients on the phone
- Proficiency in computer use while multitasking
- Ability to work 10-hour shifts on weekdays and rotating weekends, 8:00 am–7:00 pm CST
- Candidates must reside within a reasonable commuting distance from the posting location(s), unless accommodation is granted as required by law
- New candidates in certain patient/member-facing roles must become vaccinated against COVID-19 and Influenza unless they provide an acceptable explanation
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
- Virtual full-time work, except for required in-person training sessions
- Accommodation for required vaccination exemptions as permitted by law