Rx Clinical Programs ORM Pharmacy Tech

About the position

The Rx Clinical Programs ORM Pharmacy Technician Representative 2 plays a crucial role in the Pharmacy Clinical Programs Overutilization Review and Monitoring team at Humana. This position focuses on guiding members who may have medication overutilization or interaction concerns, ensuring medication safety through effective communication with healthcare providers. The role involves reviewing pharmacy histories, managing cases, and providing analytical support to enhance consumer experiences in medication management.

Responsibilities
? Assist in reviewing members' pharmacy history for overutilization.
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? Manage cases for members who would benefit from medication management programs.
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? Share results of reviews and provide analytical support for case management.
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? Take action on recommendations from case management.
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? Generate and analyze reports related to prescription fills and maintain caseloads.
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? Prepare cases for case management recommendations and take action as directed.
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? Run reports to support internal requests for data and analysis related to medication overutilization.
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? Interface with internal and external resources to address medication overutilization or drug-seeking behavior.
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? Make outbound calls to prescribers and pharmacies to validate demographics.
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? Handle inbound calls from prescribers, pharmacies, and members to educate and assist with overutilization programs.
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? Coordinate and address letter communications as directed by case management.
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? Prepare presentations and communication materials for Clinical Programs Overutilization Review and Monitoring.
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? Coordinate and plan meetings as required.

Requirements
? Pharmacy Technician license (if required to practice in the state where you live).
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? National Pharmacy Technician - PTCB or ExCPT certification.
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? 1+ years of experience working as a Pharmacy Technician.
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? Comprehensive knowledge of all Microsoft Office applications, including Access, Word, Excel, and PowerPoint.
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? Strong verbal and written communication skills, with the ability to tailor communication to the audience.
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? Ability to handle multiple tasks, meet deadlines, and follow up timely.
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? Previous experience working with data analysis and problem-solving skills.

Nice-to-haves
? Previous experience with pharmacy claims.
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? Previous experience performing pharmacy data entry.
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? Bachelor's degree in business or a related field or equivalent experience/education.

Benefits
? Medical, dental, and vision benefits.
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? 401(k) retirement savings plan.
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? Paid time off, including company and personal holidays.
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? Volunteer time off.
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? Paid parental and caregiver leave.
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? Short-term and long-term disability.
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? Life insurance.

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