The Lead Pharmacy Technician position is a supervisory position responsible for training, scheduling, and delegating daily workflow responsibilities for the technician team in addition to performing duties of a Pharmacy Technician. The Lead Pharmacy Technician will help build and lead current technician functions and communicate vital information to the technician team. The Lead Pharmacy Technician position is part of a multidisciplinary team and will work closely with Technicians, Pharmacists, Providers, Medical Directors, and other team members.

Duties & Responsibilities:

• Subject Matter Expert (SME) on all technician processes, provides support and presents resolutions.

• Leads, monitors, and delegates daily activities ensuring they are accomplished in a timely and accurate manner based on regulatory requirements.

• Assists in hiring, onboarding, training, and developing new and existing pharmacy technicians.

• Creates and maintains the pharmacy technician schedule to ensure adequate coverage to support the needs of the department.

• Performs quality assurance using internal metrics to ensure:

• Billable units are calculated correctly.

• Appropriateness of clinical reviews

• Professionalism during outreaches to members and providers as well as within the team

• Productivity and efficiency of the pharmacy technician team

• Creates and integrates new workflow improvement strategies and/or resources.

• Reviews prior authorization requests and units for medications requested under the medical benefit.

• Assesses provider-submitted clinical information for clinical appropriateness based on predetermined clinical criteria.

• Provides notification to members and providers of authorization decisions, as well as requests for information sheets.

• Performs prior authorization reviews as set forth by CMS and/or NYSDOH.

• Maintains confidentiality and compliance with Federal HIPAA regulations

• Additional duties as necessary

Minimum Qualifications:

• High School Diploma or GED from an accredited institution

• Nationally Certified Pharmacy Technician in good standing (i.e., PTCB, NHA) or registered or licensed Pharmacy Technician in good standing

• Minimum of 5-year experience conducting prior authorization reviews in the medical utilization management field.

• Ability to lead and work with a dynamic team and environment.

• Strong clinical background

• Strong written, verbal, and telephonic communication skills in English

• Knowledge of specialty pharmaceuticals and billing practices in the medical and pharmacy benefits

• Demonstrates critical thinking and problem-solving skills.

• Team player with a passion for learning and interest in growing skills in a dynamic environment with various opportunities.

Preferred Qualifications:

• Associates degree from an accredited institution

• Knowledge of specialty pharmaceuticals and billing practices in the medical benefit

• Knowledge of regulations of the Centers for Medicare and Medicaid Services including but not limited to National and Local Coverage Determinations

• PC Skills with Microsoft Word, PowerPoint (creating presentations and slides), and Excel (Pivot tables).

• Experience with TruCare Care Management Platform

• Ability to work weekends, holidays, and as needed to support departmental needs.

Compliance & Regulatory Responsibilities: Noted above.

License/Certification: Nationally Certified Pharmacy Technician in good standing (i.e., PTCB, NHA) or registered or licensed Pharmacy Technician in good standing

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

EEO Law Poster and Supplement (http://www.dol.gov/agencies/ofccp/posters)

All hiring and recruitment at Healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.

Hiring Range*:

• Greater New York City Area (NY, NJ, CT residents): $67,205 - $95,680

• All Other Locations (within approved locations): $59,800 - $87,360

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.