Job Description

Job Title: Data Entry Professional Pharmacy- Temporary
Job ID: 767370
Status: Full-Time
Regular/Temporary: Temporary
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: PHARMACY SRVCS
Location: 600 Grant St, Pittsburgh PA 15219

Description

Do you have pharmacy related experience?  Do you enjoy working in a collaborative environment?  If so, an opportunity as a Temporary Pharmacy Clinical Review Specialist I with UPMC Health Plan may be the perfect fit for you.

In this role, you will oversee administrative and system processes that relate to pharmacy prior authorizations. You will also manage the first line clinical review of prior authorization requests on behalf of physicians and UPMC Health Plan members and collaborate with clinicians regarding supporting medical documentation in accordance with formulary guidelines. You will also manage the quality review of requested prior authorizations.


Responsibilities:
  • Greet and assist any visitors to the department
  • Maintain and purchase office supplies as needed
  • Maintain neat and organized files and electronic databases
  • May entail work with Microsoft Office products such as Word, Excel, Outlook and PowerPoint.
  • Perform other duties as assigned
  • Prepare letters, memos, and reports
  • Schedule and coordinate internal and external appointments, calendars, and meetings
  • Support all department personnel with duties including but not limited to answering phones, taking messages, copying, filing and faxing

Qualifications

  • HS diploma required. 
  • Pharmacy claims, pharmacy tech, and/or other related experience in a physician practice, ancillary provider, or other relevant healthcare setting preferred. 
  • Competent in pharmacy claims process operating system. 
  • Excellent knowledge in UPMCs Health Plan internal department functions. Excellent knowledge of medical terminology, coordination of benefits, complaints and grievance guidelines and prescription drug utilization management requirements.  
  • Thorough knowledge in MS Office and PC skills required. Organizational, analytical, interpersonal, and communication skills.  
  • Ability to prioritize and perform multiple tasks while maintaining designated production and quality standards. 
  • Staff is required to work scheduled overtime and be available for emergency overtime as business needs dictate.  
  • Staff is required to work a temporary, alternative schedule or shift as requested by supervisor.

Licensure, Certifications, and Clearances:
  • Act 34 Criminal Clearance or Act 34 Criminal Clearance with Renewa

UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $0

Union Position: No

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