Pharmacy Technician III - CarelonRx

Anticipated End Date:

2025-12-08

Position Title:

Pharmacy Technician III - CarelonRx

Job Description:

Pharmacy Technician III - CarelonRx

Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.

A proud member of the Elevance Health family of companies, CarelonRx (formerly IngenioRx) leverages the power of new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care.

The Pharmacy Technician I 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:

• 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:

1st Shift (United States of America)

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

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 40