Insurance Green Card Sponsorship Jobs in California

INTRODUCTION

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

ROLE AND RESPONSIBILITIES

The Pharmacy Technician performs department administrative functions that do not require the Pharmacy Managers judgment. Responsible for the administrative and clerical support directly involved with the day-to-day operations of the multiple programs performed by the department. Performs assigned tasks to meet AHP HMO and Pharmacy Department goals.

GENERAL DUTIES/RESPONSIBILITIES:

1. Assists with the daily operations of the various Pharmacy Department programs, multiple projects and participate in Plan and regulatory agency audits, as necessary.

2. Makes high volume of outbound calls to members, prescribers, and pharmacies in regard to the Adherence program.

3. Assists members in refilling their medications and reaching out to the prescriber’s office if a member requires additional refills on their maintenance medications.

4. Drafts routine reports and correspondence.

5. Supports all CMS required oversight processes of PBM including but not limited to: Rebates, Explanation of Benefit reports, Transition Reports, and Part B vs Part D.

6. Responds to inquiries from physicians, members, and pharmacies related to formulary and prescription benefits.

7. Retrieves accurate, concise, applicable, and timely drug information.

8. Interacts with Plan's contracted PBM to ensure communications and information to other internal Plan departments as applicable.

9. Interacts with Plan’s contracted PBM in regard to Prior Authorizations, Overrides and in resolving issues pertaining to member’s medications.

10. Makes outbound calls to pharmacies and prescribers to resolve prescription issues such as medication requires Prior Authorization, assist retail/mail order pharmacies in resolving third party rejections, and reviewing daily rejections while ensuring we are CMS compliant.

11. Interacts with internal plan departments to address pharmacy related issues.

12. Works closely with compliance department to make sure Pharmacy Programs meet the criteria established by CMS.

13. Ensures all HMO’s members information is kept confidential according to HIPAA.

14. Other duties as assigned.

BASIC QUALIFICATIONS

Experience:

Required: Minimum 1 year customer experience.
Preferred: Prior Pharmacy Tech experience in a healthcare setting.

Education:

Required: High School Diploma or GED.
Preferred: Associates Degree in Pharmacy Tech

Training:

Required: None
Preferred: Pharmacy Tech school

Specialized Skills:

Required:
* Knowledge of pharmacy and medical nomenclature/terminology, common medication dosages, trade & generics, and medication therapy application.
* Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.
* Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors;
* Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly
* Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.
* Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.
Preferred: Bilingual - English/Spanish or English/Chinese

Licensure:

Required: Pharmacy Tech license
Preferred: Certified Pharmacy Technician

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. While performing the duties of this job, the employee is regularly required to talk, hear, and sit; use hands to manipulate office equipment.

2. The employee regularly is required to stand, walk, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.

3. The employee frequently lifts and/or moves up to 10 pounds.

4. Specific vision abilities required by this job include close vision and the ability to adjust focus.

COMPENSATION

Pay Range: $41,472.00 - $62,208.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email careers@ahcusa.com.