Pharmacy Tech III (US)

Anticipated End Date:

2026-02-14

Position Title:

Pharmacy Tech III (US)

Job Description:

Pharmacy Technician III

Location: This role requires associates to be in-office [3] days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. This position will be based on PR-SAN JUAN, 1001 SAN ROBERTO ST, STE 101, 401 & 501.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Schedule: This position will work an 8-hour from shift 8:00 am - 6:00 pm (AST) Monday to Friday.  Additional hours may be necessary based on company needs.

Carelon is a proud member of the Elevance Health family of companies providing unparalleled level of service in pharmacy benefits. By leveraging the power of new technologies, our strong, clinical-first lens and deep pharmacy expertise, we are actively defining our innovative role in the industry.

The Pharmacy Technician III is responsible for interpretation and data entry of complex prescriptions, prior authorization processing, and troubleshooting adjudication issues. Reviews requests by mail, telephone, or electronically and responds to inquiries and interprets requests to determine the most effective response.

How you will make an impact.

Primary duties may include, but are not limited to:

• Verifies member and provider information and inputs data for the pharmacists and other clinicians to review.  
• Processes prior authorization requests from physicians’ offices and ensures compliance with all Medicaid, Commercial, and Medicare requirements; informs relevant parties of all prior authorization determinations.
• Managing inbound and outbound communications, triaging and problem-solving pharmacy inquiries, ensuring any related patient and prescriber communication is completed and resolving all related open cases across patient services tool and pharmacy processing system, and managing prescription queue workflow.
• Manage and support more complex inquiries and support other lower level pharm techs.
• Provides resolution to grievances and appeals issues.
• Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits.
• Manages escalations and analyzing data and results of any process improvements.
• Generates reports related to necessary data for respective department, as well as other ad hoc reports as needed.
• Works in applicable queues, supporting clinicians and operations leadership with inbound requests in all lines of business.
• Acting as a subject matter expert in all respective areas and lines of business and maintains knowledge of new tasks to ensure continued education and support.
• Mentors and trains lower-level pharmacy technicians as needed.

Minimum Requirements:

• Requires H.S. diploma or equivalent and minimum of 5 years of pharmacy experience.
• Requires an active, valid, current and unrestricted state Pharmacy Technician license or national license based on applicable state(s) requirements to practice as a Pharmacy Technician within the scope of practice in a state or territory of the United States.
• Multi-state certification is required if this individual is providing services in multiple states.

For URAC accredited areas, the following professional competencies strongly preferred: strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. Certified Pharmacy Technician preferred.

Job Level:

Non-Management Non-Exempt

Workshift:

Job Family:

MED > Licensed/Registered Pharmacist/Pharmacy Technician

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work