Pharmacy Technician

Reviews and processes formulary change requests from Health Net plans

Submits and maintains formulary change requests to Health Net’s pharmacy claims processor

Generates, maintains and reviews Formulary Status Grids

Uses reports to perform audits and quality checks on the current formulary status for accuracy and contract compliance

Assists Clinical Pharmacist with formulary database maintenance and updates to company web site

Pharmacy Audit and Recovery:

Performs a variety of assignments required for pharmacy audit and recovery functions

Reviews paid claims for quantity and/or billing discrepancies. Corresponds with pharmacies as needed to communicate review finding

Faxes inquiries to pharmacies related to review findings

Answers in-coming calls and responds appropriately to faxed correspondence from pharmacies

Updates Access database with incoming phone calls, faxes and e-mails

Performs other duties as assigned

Complies with all policies and standards

The Pharmacy Technician may perform duties in one or more of the following areas: Formulary Management, Pharmacy Audit and Recovery, Pharmacy Service Center, Medicare Part D/Part B, Appeals, Medicare Part D Operations and State Health Programs Pharmacy Operations or Prior Authorization. Using established company guidelines, the Pharmacy Technician reviews requests made by physicians, medical groups, pharmacies and members for the use of prescription drugs and pharmacy benefits. The technician researches and resolves questions, problems or issues. May consult with Clinical Pharmacists or Regional Medical Director on related issues. Education/Experience: High School diploma or GED required. 1 year Pharmacy Technician experience. Customer Service/retail experience preferred License/Certification: Valid Pharmacy Technician License preferred.

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.