Details
Posted: 16-Mar-23
Location: Boise, Idaho
Salary: Open
Categories:
Pharmacy
Overview
The Pharmacy Benefits Management Services (PBM) Department
at St. Luke's is growing,and we are seeking several high-performing
PBM Services Technicians
to join our dynamic, exciting, and progressive team!
**SIGNING BONUS!!**
Monday - Friday day shift
No weekends - No holidays
What will I do as a PBM Services Tech?
The PBM Services Pharmacy Technician assists our members in identifying and navigating complex PBM and 3rd party issues such as Prior Authorization, Step Therapy, reviewing denied claims, processing overrides, and so on.
You'll work with an interdisciplinary team of Pharmacy staff, Patient Financial Advocates, the Pharmacy Authorization Team, Revenue Cycle, third party vendors, clinic staff, and providers.
You'll issue insurance overrides, approve/deny prior authorizations, and make decisions that will lead to therapy being approved or denied. The PBM Services Pharmacy Technician will review the supporting clinical documentation provided by a patient's prescriber and validate that information against the drug and therapeutic indication for that situation. The attention to detail will result in a patient being approved or denied the therapy that is being requested by the physician. Additionally, you'll address complex questions from both third-party payers and SLHS personnel regarding medication issues and reimbursement.
What qualifies me for this position?
To be considered for this position, you need a high school diploma or equivalent and a valid Idaho Pharmacy Technician License.
The PBM Help Desk team requires pharmacy technicians with knowledge on the complexities spanning across not only retail pharmacy operations but also insurance billing and insurance benefits/ plan designs.
The perfect team member will have strong communication skills, problem-solving abilities, a professional presentation, and a desire or ability to be innovative and creative. Other knowledge, skills, and abilities include:
- Ability to establish and maintain collaborative working relationships
- In-depth knowledge of high-cost specialty medications as well as the applicable regulatory matters that are often times unique to a particular patient and financial situation
- Knowledge of federal laws that may impact patients from participating in manufacturer copay card programs
- Strong math skills to be able to calculate costs and savings with specialty medications
- Familiarity with Microsoft applications such as Excel, Teams, Outlook, and SharePoint
Why St. Luke's
A strong, talented staff is at the heart of St. Luke's Health System. We are the state's largest employer with more than 15,000 employees and a medical staff of more than 1,800 physicians and advanced practice providers. We're proud of our people who deliver skilled, compassionate care every day, and are looking to add dedicated individuals who will continue this same tradition of excellence.
About Boise
Known as the "City of Trees," Boise is Idaho's capital city--both a cultural center and a playground for those who love the outdoors. A vibrant downtown area affords fine dining, theatre, music, and college and semi-professional sports. Downtown Boise's main attractions include the Idaho State Capitol, the classic Egyptian Theatre, the Boise Art Museum, Julia Davis Park and Zoo Boise. The Greenbelt follows the beautiful Boise River corridor for more than 30 miles, and the Boise foothills are home to miles of hiking and biking trails.
Learn more about what the City of Trees has to offer you:
St. Luke's Health System | Boise Convention and Visitors Bureau | Boise Parks and Recreation | Boise Museum Association | Boise Music Festival | Boise Philharmonic | Downtown Boise Restaurants | Boise Valley Economic Partnership | Hyde Park events | Treefort Music Festival | First Thursdays | Alive After Five | Capitol City Public Market | Runs and Triathlons | Shakespeare Festival | Sawtooth National Forest | Visit Idaho.org
*St. Luke's is an equal opportunity employer and does not discriminate against any person on the basis of race, religion, color, gender, gender identity, sexual orientation, age, national origin, disability, veteran status, or any other status or condition protected by law.