Job Description

CarelonRx Pharmacy is now part of CarelonRx (formerly IngenioRx), a proud member of the Elevance Health family of companies. The CarelonRx Home Delivery Pharmacy will deliver a digital first pharmacy experience that is convenient, simpler to use, and more affordable for our patients and payors. Our Pharmacy model focuses on whole person care, providing the best member experience to drive adherence, affordability, and improved overall health outcomes by putting the patient first.

Pharmacy Tech III Dispensing

Location:

This role requires associates to be in-office

1 - 2

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.

Alternate locations may be considered if candidates reside within a commuting distance from an office

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 a first shift Monday thru Friday. There may be flexibility depending on the time zone in which candidate resides.


The

Pharmacy Tech III

Dispensing will perform all pharmacy technician duties under the regulatory authority of the state they are practicing in and aid in the dispensing of prescriptions to patients by the CarelonRx Pharmacist. Responsible for complex pharmacy, patient, and prescriber encounters, including, but not limited to prescription claim adjudication exceptions, returns, reships, drug recalls, and patient and prescriber escalations.

Primary duties may include, but are not limited to:

Educates members on pharmacy-based rules related to prescriptions and medication resources or assistance programs. Serves as the subject matter expert, proactively manages service failures and workflow in our contact center tool and our prescription processing system. Partner and support pharmacists in the performance of their duties, including outreach to patients and prescribers for resolution on open issues. Processes prior authorization requests from physicians and ensures compliance with all regulatory requirements. Informs relevant parties of all prior authorization determinations. Provides resolution to grievances and appeals issues. 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. Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits. Generates reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports. Mentor and train lower-level pharmacy technicians as needed; as well as lead pharmacy technicians working prescription queue-based assignments to ensure quality, meeting turnaround times, and delivering on patient, prescriber, and client experience and expectations.

Minimum Requirements:

Requires H.S. diploma or equivalent and minimum of 5 years of pharmacy experience. Requires an active, professional license, if required by state law(s), State Pharmacy Technician Certification or National Certification 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. Experience with PBM/Plan insurance setup and processing and claims adjudication and resolution of reject messaging required.

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.




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, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.


Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.


The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.


Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.


Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.