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Anthem, Inc. Spec Med Mgmt Tech Sr in Deerfield, Illinois

Description

SHIFT: Day Job

SCHEDULE: Full-time

Summary: Responsible for the interpretation of moderately complex specialty drug prior authorization requests, processing prior authorizations , and for troubleshooting process and system issues.

Primary duties may include, but not limited to:

  • Verifies member information and reviews prescriber requests for specialty medical reviews via prior authorization system

  • Processes prior authorization requests from physician offices and ensures compliance with criteria and plan requirements

  • Interprets prior authorization requests using system logic and applicable departmental workflow processes

  • Ability to communicate effectively with technicians and pharmacists to support the case review process

Qualifications

Qualifications:

  • High School diploma required

  • Minimum 2 years of pharmacy experience or any combination of education and experience, which would provide an equivalent background

  • Requires current unrestricted Pharmacy Technician License in state of practice AND national certification issued by PTCB

  • Experience with MS Office Suite (specifically Outlook, Word and Teams) and skilled in written, oral and interpersonal communications required

  • Retail pharmacy experience required

  • Managed Care experienced strongly preferred

  • Call Center experience strongly preferred

  • Shift will range from 8am-8pm Monday-Friday, including rotating weekends and holiday coverage

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.

REQNUMBER: PS40980

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