Job ID: JP00044453

Anticipated Start Date: 05/13/2024

Please note this is the target date and is subject to change. BCforward will send official notice ahead of a confirmed start date.

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for contract workers (via BCforward) who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

Responsible for the interpretation and data entry of basic prescriptions, prior authorization processing, and troubleshooting adjudication issues.

Primary duties may include, but are not limited to:

• Verifies member information and inputs data for the pharmacists.
• Educates members on pharmacy based rules related to prescriptions and medication resources or assistance programs.
• Processes prior authorization requests from physicians offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations.
• Provides resolution to grievances and appeals issues.
• 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.
• Maintains record keeping of prior authorizations, rebates, and monthly reports.
• Assists the Pharmacist in reviewing, processing, preparing, filling, labeling and dispensing of medications and supplies.
• Arranges work activities so that the pharmaceutical needs of customers are met.
• Responsible for compliance with Florida statute 64B16-27.420 Pharmacy Technician regulations from the State of Florida Board of Pharmacy.
• Answers phones, respond to questions and requests or refer them to appropriate staff for medication information. Knowledgeable of phone etiquette skills.
• Maintains records by recording and filling physician’s orders and prescriptions.
• While completing Data Entry Department related functions, request and process prior authorizations.
• Maintains a clean and safe pharmacy by complying with procedures, rules and regulations.
• Communicates effectively with other professional and support staff in order to achieve positive customer outcomes.
• Promotes and contributes to a positive, problem-solving environment.
• Assists customers, family members and others with concern and empathy; respect their confidentiality and privacy and communicate with them in a courteous and respectful manner.
• Complies with company policies and procedures and maintains confidentiality of customer medical records in accordance with state and federal laws.
• Ensures compliance with all HIPAA, OSHA, and other federal, state, and local regulations.
• Participates in meetings, training, and in-service education, as required.

Requirements:

• Requires a high school diploma.
• 1 year of pharmacy experience; or any combination of education and experience, which would provide an equivalent background.
• Current State (FL) Pharmacy Tech Licensure.
• Certification or National Certification based on applicable state(s) required.
• Level II Fingerprint screening required.
• Previous experience in pharmacy environment and pharmacy terminology.
• Excellent computer knowledge is required, including proficient knowledge of Microsoft Office.
• Fluency in Spanish and English preferred.
• Call Center skills required. Customer relations experience helpful.
• Must be patient in dealing with an elderly population and sympathetic to hearing or vision deficiencies.
• Excellent listening, interpersonal, verbal and written communication skills with individuals at all levels of the organization.
• Ability to work effectively independently and in a team environment.
• Must be self-motivated, organized and have excellent prioritization skills.
• Must be able to work well under stressful conditions.
• Must be able to work in a fast paced environment.

Job Type:Contract role.

Additional Details:

• COVID-19 vaccination required.
• Shifts: Monday-Friday 8:00 am- 4:30 pm.
• Position 100% onsite.
• Work location: 4850 W. Oakland Park Blvd, Lauderdale Lakes, FL, USA, 33313.

About BCforward:

Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward’s 6,000 consultants support more than 225 clients globally.

BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.

BCforwardis an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.

To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.

This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.