AmeriHealth Caritas Formulary/Drug Utilization Review Technician in Philadelphia, Pennsylvania

Formulary/Drug Utilization Review Technician

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At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com .


Description

PerformRx is a pharmacy benefits manager (PBM) dedicated to clinical culture, boutique service and holistic solutions. Our mission is to help customers, doctors and patients use effective medication therapy to improve health and wellness. For more than 15 years, our focus has been on providing optimal service through a clinical culture which seeks to provide members with high quality care while ensuring our partners receive favorable costs. That culture is reflected in our employees - more than 80 percent of our staff members are Pharmacists and Pharmacy Technicians - and in the services we provide.

PerformRx is headquartered in Philadelphia with offices on both coasts, leading to better pharmacy benefit management across the nation. Our dedication to innovation and to providing the most efficacious outcomes is the core of our clinical culture and is the heart of PerformRx. PerformRx is a subsidiary of the AmeriHealth Caritas Family of Companies.

Responsibilities:

  • Completes administrative and technical tasks to support the Clinical Services Department.
  • Responds to questions, provides clarifications, and reacts to requests regarding FM/DUR. Complex issues/questions will be forwarded to Department Manager.
  • Maintains formulary files In Formulary Management application.
  • Supports the needs of the management team through electronic mining/data retrieval, data analysis and report generating including and not limited to all technical FM reports, Rx Focus DUR reports, Pharmacy & Therapeutic Committee needs, and exporting and dissemination of DUR reports to FM pharmacists.
  • Submits coding to claims processor.
  • Completes appropriate testing of coding changes to ensure they are processing as expected.

Education/Experience:

  • High School Diploma or equivalent required
  • Associate's degree preferred
  • Current Pharmacy Technician Certification (PTCB or NCCT)
  • Minimum 3 years healthcare experience
  • Managed care experience preferred

EOE Minorities/Females/Protected Veterans/Disabled