Employment Spot

Job Description

Description of Pharmacy Technician:

Key Relationships:

Reports To: AVP of Pharmacy

Supervises: None

Other Key Relationships: Clinical Pharmacists

FLSA: Non-Exempt

Position Purpose:

• The responsibilities of this position include the coordination and monitoring of pharmacy benefit management activities to meet all regulatory and accreditation requirements.
• This position acts as the first line of contact for both internal and external customers.
• The position acts to support the AVP of Pharmacy and clinical pharmacists in the planning, development, implementation and administration of pharmacy programs.

Principle Duties:

• Manages the day to day pharmacy questions and processes
• Acts as the first point of contact with CHP’s internal and external customers
• Coordinates and monitors formulary management with PBM-includes maintaining records of changes in processes and appropriate monitoring/ auditing of PBM adherence to the formulary and to any changes in conjunction with CHP operations.
• Generates all required pharmacy reports
• Performs all CMS and NCQA required monitoring activities and coordinates the completion of corrective action plans, when needed.
• Monitors and analyses CMS guidance and report to pharmacists regarding actions to be taken to ensure Part D compliance.
• Uploads reports to CMS
• Research and correct PDE errors
• Supports the pharmacists in developing and implementing pharmacy intervention programs
• Maintains pharmacy workplan
• Other duties as assigned.

Job Requirements

Requirements of Pharmacy Technician:

Qualifications:

Education

• Pharmacy Technician Certified (Class A):
• Bachelor of Science in related field beneficial, but not required

Prior Related Experience:

• 2 plus years of experience in managed care pharmacy setting (pharmacy utilization management)
• Experience in project coordination

Employment Eligibility:

• Candidate has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency.

Knowledge, Skills, and Abilities:

• Strong clinical skills and knowledge of formulary management and clinical program development.
• Ability to manage multiple, complex, concurrent projects.
• Strong analytical skills
• Strong project coordination skills
• Excellent written and verbal communication skills.
• Excellent organizational and planning skills
• Ability to work as a team member as well as independently.
• Self-starting and highly self motivated
• Strong PC operation skills that include but not limited to Word, Excel, Visio, Access and PowePoint.
• Strong interpersonal skills.
• Ability to travel as necessary.

Sensory/Physical/Mental Requirements:

Sensory:

• Speaking, hearing, near vision, far vision, depth perception, peripheral vision, touch, smell, and balance.

Physical:

• Extended periods of sitting, computer use, talking and possibly standing.
• Simple grasp, firm grasp, fine manipulation, pinch, finger dexterity, supination/pronation, wrist flexion.
• Frequent torso/back static position; occasional stooping, bending and twisting.
• Some kneeling, pushing, pulling, lifting and carrying (not over 25 pounds), twisting and reaching.

Mental:

• Must have the ability to learn and prioritize multiple tasks within the scope and guidelines of the position and its applicable licensure requirements, many requiring extremely complex cognitive capabilities. Must be able to manage conflict, communicate effectively and meet time-sensitive deadlines.

Candidates whose disabilities make them unable to meet these requirements will still be considered fully qualified if they can perform the essential functions of the job with reasonable accommodation.

Work Environment: 

Office environment with frequent environmental exposure to low-grade radiation from computer monitors; fast paced with frequent interruptions.

Protected Health Information (PHI) Access: 

Community Health Plan employees will encounter protected health information in the regular course of their work at and for Community Health Plan. Community Health Plan is a Covered Entity engaging in Health Care Service Contractor treatment, payment and operations. The following scale intends to provide some indication of how often the employee may encounter or work with PHI in this particular role. All PHI shall be used and disclosed on a Need To Know Basis and according to HIPAA Privacy Rules Part 164. In addition, every employee shall sign a confidentiality agreement as a condition of employment and violation of that agreement and/or Community Health Plan policies can be cause for termination.

PHI is defined at 164.103 as: 

"Protected health information means the individually identifiable health information that is (i) Transmitted by electronic media; (ii) Maintained in electronic media; (iii) Transmitted or maintained in any other form or medium.
Individual means the person who is the subject of protected health information.
Individually identifiable health information is information that is a subset of health information, including demographic information collected from an individual, and:

1. Is created or received by a health care provider, health plan, employer, or health care clearinghouse; and
2. Relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual; and

• That identifies the individual; or
• With respect to which there is a reasonable basis to believe the information can be used to identify the individual.
  This position as described will use, encounter, read, create, disclose and or work with in general, PHI that is created by or received by Community Health Plan:

• Frequent - The position has frequent and/or daily access and responsibility for PHI. Need to know.
• In all cases, PHI use and disclosure is limited to the minimum necessary amount of PHI needed to complete the treatment, payment or operations.

The above is intended to describe the general content of and the requirements for satisfactory performance in this position. It is not to be construed as an exhaustive statement of the duties, responsibilities or requirements of this position.

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