Job Information

G-TECH Services, Inc. Prior Authorization Specialist in Detroit, Michigan

Engagement Description – Pharmacy technician will work in a provider call center with pharmacy services intaking requests for prior authorizations and handling inquiries related to general utilization management claims rejections for both Blue Care Network and Blue Cross Blue Shield of Michigan commercial members.

Top 3 Required Skills/Experience –

• Excellent knowledge of pharmacy benefit drugs and utilization management

• Excellent computer skills utilizing web-based applications and windows 10

• Ability to professionally service provider calls in a call center environment

Required Skills/Experience – The rest of the required skills/experience. Include:

• Excellent written and verbal communication skills

• Ability to problem solve and resolve issues referencing desk level procedures

• Comfort with ambiguity in an area where processes and procedures are updated on a daily basis

• Attention to detail to ensure adherence to NCQA standards and time frames

Preferred Skills/Experience –

• Prior Health plan experience a plus

• Specialty pharmacy experience a plus

• Medical benefit drug billing and utilization management experience a plus

Education/Certifications – Include:

• Michigan license as a pharmacy technician

Category Analyst

Function Information Technology

Req ID JN -072022-118338

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