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Salary
$45k – $60k per year
Location
Remote (United States)
Employment
Full-Time
Overview
Company
Impact
Profile match
Humana is an American health insurer founded in 1961 that began as a nursing home operator, moved into hospitals, and eventually sold those to concentrate entirely on health benefits. It is one of the largest providers of Medicare Advantage plans in the United States, where private insurers administer government-funded coverage for older Americans, and it also runs CenterWell, a care delivery arm operating primary care clinics, home health services and a pharmacy. Headquartered in Louisville, Kentucky and listed on the New York Stock Exchange, its results are unusually sensitive to Medicare rate decisions and to how quality star ratings are assessed.

Become a part of our caring community

The Consultative Pharmacy Technician 3 certified Pharmacy Technician who acts as an intake for all calls from patients, pharmacies and providers. The Consultative Pharmacy Technician 3 performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills.

The Consultative Pharmacy Technician 3 reports to a supervisor of Consultative Pharmacy and supports the interdisciplinary CIT team by helping resolve medication access barriers for primary care-managed medications.

This role assists with:

  • Medication list reviews
  • Formulary and cost-management needs,
  • Patient Assistance Program applications,
  • Low Income Subsidy screening and enrollment support,
  • Medicare Prescription Payment Plan education,
  • Pharmacy-related access issues,
  • Manages referrals through established workflows,
  • Conducts patient outreach
  • Coordinates with clinics and providers
  • Documents case activity
  • follows program guidelines to support timely and appropriate medication access assistance.

Additional responsibilities include:

  • Know and continually review medication brand and generic names, medical terminology, and pharmaceutical calculations.
  • Medication adherence outreach, auditing, documenting, and reporting as it pertains to STAR measures when applicable.
  • Responsible for interacting with other departments to assist with member problems or questions and act as facilitator to resolve them regarding prior authorization or obtaining medications.
  • Attend scheduled team meetings and provide relevant feedback regarding workflow issues.
  • Receive and manage referrals submitted through the Internal Medication Access Program referral process.
  • Responsible for initiating and following through with patient assistance programs, prior authorizations, formulary exceptions/alternatives, and tier reductions to help patients afford their medications.
  • Provide role-appropriate assistance for pharmacy-related access issues (Medication packaging education, Pharmacy transfers, third party rejections and override assistance).
  • Processing of select medication claim updates (lists) as requested by the clinical pharmacists or providers.
  • Document outreach attempts, outcomes, and case status updates according to workflow requirements.

Use your skills to make an impact

Required Qualifications

  • Completion of an accredited Pharmacy Technician Program
  • Active unrestricted State Pharmacy Technician License in your state of residence.
  • PTCB Certified with Medication Therapy Management (MTM) Certification or ability to obtain MTM Certification within 60 days of hire date.
  • Minimum three (3) more years of experience as a Pharmacy Technician
  • Knowledge of the top 200 drugs
  • Comfortable working with or learning electronic health record systems
  • Prior Authorization experience
  • Pharmacy Benefit Management experience

Preferred Qualifications

  • Mail Order Pharmacy experience
  • Bilingual in Spanish

Workstyle: Remote Work at Home

Location: Nationwide

Schedule: M-F 8:00-5:00 PM local time

Travel: None at this time

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$44,900 - $60,200 per year

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient’s well-being.About CenterWell, a Humana company: CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high-quality healthcare that is accessible, comprehensive and, most of all, personalized. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. CenterWell is part of Humana Inc. (NYSE: HUM). Learn more about what we offer at CenterWell.com.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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