San Francisco Health Plan

  • Pharmacy Technician Specialist

    Job Locations US-CA-San Francisco
    Job ID
    2019-1521
    Category
    Health Services
    Type
    Regular Full-Time
  • Overview

    Do you take pride in knowing that your work positively impact thousands of lives? Do you thrive in a mission-driven, fast-paced, collaborative environment where the frontier of healthcare is constantly being pushed?

    In the role of Pharmacy Specialist you will be responsible for working with a multi-disciplinary team, serving as both a lead for the retail pharmacy relationships, specialty pharmacy vendor management and customer service support for member inquiries regarding the pharmacy benefit.  You will also participate in PBM (Pharmacy Benefit Manager) oversight and monitoring functions, work with members and providers over the telephone, as well as data entry.  The position provides opportunities to work on drug utilization management programs,  pharmacy authorization requests, MTM (Medication Therapy Management) for individual members and vendor audits contingent upon departmental needs. This position will be cross-trained in several key positions within the Health Services Pharmacy department.

     

     

    WHAT YOU WILL DO

     

    • Provide oversight and coordination of the retail pharmacy network in collaboration with the PBM as well as specialty pharmacy vendor management.
    • Provide oversight, monitoring and audits of PBM activities including claim processing, network management and benefit.
    • Research medical and pharmacy utilization management requests using a variety of resources including SFHP evidence of coverage, policies and procedures, electronic resources and medical journals.
    • Refer cases to a clinician, including the Medical Director, for clinical review, potential denial or modification and physician provider education.
    • Provide administrative, clerical and analytic support for clinical pharmacy programs including the P&T Committee and drug utilization management activities.
    • Maintain databases and provide analysis as needed for operational reporting requirements.
    • Answer questions and resolve issues promptly from providers, office staff, and pharmacy staff pertaining to medical supply benefits, formulary and preauthorization requirements.
    • Ensure the privacy and security of PHI (Protected Health Information) as outlined in SFHP's policies and procedures relating to HIPAA compliance.
    • Make telephone calls to members according to SFHP utilization, case and disease management program protocols.
    • Enter required data in various computer programs and databases.

      

    WHAT YOU WILL BRING

     

    • A current CA Pharmacy Technician License without restriction.
    • A Bachelor’s degree in Social Sciences, Life Sciences, Business or a related field, preferred or equivalent work experience.
    • A minimum of three years of related pharmacy experience.
    • Demonstrated PC and MS Office skills (Word, Excel, PowerPoint, Outlook).
    • Experience with Medi-Cal and/or Department of Health Care Services regulations and standards, preferred.
    • Experience in an HMO or experience in a managed care setting, a plus.
    • Knowledge of and experience with state and federal insurance programs, a plus.

     

    ABOUT US

     

    Established in 1997, San Francisco Health Plan (SFHP) is a an award winning,  managed care health plan whose mission is to provide affordable health care coverage to the underserved low and moderate-income residents in San Francisco county. SFHP is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and its 145,000+ members have access to a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning services. SFHP was designed by and for the residents it serves, and takes great pride in its ability to accommodate a diverse population that includes young adults, seniors, and people with disabilities.

    San Francisco Health Plan is an Equal Opportunity Employer (EOE M/F/D/V)

    Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

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