Pharmacy Technician - Central PA Team
- Req #: 11319
- Address: 2123 Auburn Ave
- City, State: Cincinnati, OH
- Zip: 45219
- Shift: Day
Job Description
The Pharmacy Technician provides support to pharmacists and managers in all aspects of providing pharmacy services. Under the general supervision of the Assistant Director of Pharmacy, and according to standard procedure, a prior authorization pharmacy technician completes prior authorizations upon receiving orders from a licensed practitioner; performs all duties necessary to provide for the effective daily operation of all departmental services and program
Responsibilities
1. View & Evaluate PA Requests
Analyze PA submissions from providers to ensure they meet clinical and formulary guidelines.
Review patient history, lab results, and diagnosis codes when available.
Assess medical necessity based on criteria such as FDA-approved indications, compendia, and internal policies.
2. Apply Clinical Criteria
Use evidence-based guidelines (e.g., Medicare Part D, NCCN, IDSA, ADA) to determine approval or denial.
Identify off-label use and evaluate its appropriateness.
3. Communicate with Providers
Request additional documentation or clarification when needed.
Explain coverage decisions and educate on formulary alternatives or step therapy requirements.
4. Document & Process Authorizations
Enter decisions into pharmacy benefit management (PBM) or health plan systems.
Ensure accurate record-keeping for compliance and audit purposes.
5. Collaborate with Internal Teams
Work with case managers, medical directors, and utilization review teams.
Participate in interdisciplinary discussions about complex or high-cost cases.
6. Monitor for Compliance & Fraud
Identify potential overuse, misuse, or inappropriate prescribing patterns.
Flag questionable cases for further investigation.
7. Maintain Up-to-Date Knowledge
Stay current on formularies, new drug approvals, clinical guidelines, and payer policies.
Attend continuing education and internal training sessions.
8. Support Appeals Process
Prepare clinical rationales for appeal responses in conjunction with a pharmacist
Review new evidence submitted during appeal reviews.
9. Provide Education
Educate prescribers, patients, and internal staff about prior authorization processes and criteria.
Help reduce PA burden through proactive outreach and education on preferred alternatives.
10. Quality Assurance & Process Improvement
Participate in audits and contribute to quality improvement initiatives.
Help streamline workflows and improve efficiency in the PA process.
As a representative of The Christ Hospital Health Network and Department of Pharmacy Services, promotes a positive image in all dealings with all other hospital associates and hospital customers.
Performs other duties as deemed necessary by the Director of Pharmacy, Assistant Director, and pharmacists.
Potential for exposure to hazardous and toxic substances.
Qualifications
KNOWLEDGE AND SKILLS:
Please describe any specialized knowledge or skills, which are REQUIRED to perform the position duties. Do not personalize the job description, credentials, or knowledge and skills based on the current associate. List any special education required for this position.
EDUCATION:
High school diploma or GED
YEARS OF EXPERIENCE:
A minimum of 2 years of retail experience.
REQUIRED SKILLS AND KNOWLEDGE:
Must have performance appraisals documenting the following:
- A work history of qualitative consistency, productivity and appropriate interdependence.
- A work history of initiative, motivation and flexibility.
- A work history of above average quality, quantity and knowledge of work.
- A work history of above average attendance and reliability.
LICENSES & CERTIFICATIONS:
The person has passed an examination approved by the Ohio State Board of Pharmacy, PTCB/ CPhT.
Person must register as Technician in Training with Ohio State Board of Pharmacy, if not currently registered with the Ohio State Board of Pharmacy. Upon completion of training period the person must complete registration as Certified Technician with the Ohio State Board of Pharmacy. The person must keep active certification with the Ohio State Board of Pharmacy.
The Pharmacy Technician provides support to pharmacists and managers in all aspects of providing pharmacy services. Under the general supervision of the Assistant Director of Pharmacy, and according to standard procedure, a prior authorization pharmacy technician completes prior authorizations upon receiving orders from a licensed practitioner; performs all duties necessary to provide for the effective daily operation of all departmental services and program
Responsibilities
1. View & Evaluate PA Requests
Analyze PA submissions from providers to ensure they meet clinical and formulary guidelines.
Review patient history, lab results, and diagnosis codes when available.
Assess medical necessity based on criteria such as FDA-approved indications, compendia, and internal policies.
2. Apply Clinical Criteria
Use evidence-based guidelines (e.g., Medicare Part D, NCCN, IDSA, ADA) to determine approval or denial.
Identify off-label use and evaluate its appropriateness.
3. Communicate with Providers
Request additional documentation or clarification when needed.
Explain coverage decisions and educate on formulary alternatives or step therapy requirements.
4. Document & Process Authorizations
Enter decisions into pharmacy benefit management (PBM) or health plan systems.
Ensure accurate record-keeping for compliance and audit purposes.
5. Collaborate with Internal Teams
Work with case managers, medical directors, and utilization review teams.
Participate in interdisciplinary discussions about complex or high-cost cases.
6. Monitor for Compliance & Fraud
Identify potential overuse, misuse, or inappropriate prescribing patterns.
Flag questionable cases for further investigation.
7. Maintain Up-to-Date Knowledge
Stay current on formularies, new drug approvals, clinical guidelines, and payer policies.
Attend continuing education and internal training sessions.
8. Support Appeals Process
Prepare clinical rationales for appeal responses in conjunction with a pharmacist
Review new evidence submitted during appeal reviews.
9. Provide Education
Educate prescribers, patients, and internal staff about prior authorization processes and criteria.
Help reduce PA burden through proactive outreach and education on preferred alternatives.
10. Quality Assurance & Process Improvement
Participate in audits and contribute to quality improvement initiatives.
Help streamline workflows and improve efficiency in the PA process.
As a representative of The Christ Hospital Health Network and Department of Pharmacy Services, promotes a positive image in all dealings with all other hospital associates and hospital customers.
Performs other duties as deemed necessary by the Director of Pharmacy, Assistant Director, and pharmacists.
Potential for exposure to hazardous and toxic substances.
Qualifications
KNOWLEDGE AND SKILLS:
Please describe any specialized knowledge or skills, which are REQUIRED to perform the position duties. Do not personalize the job description, credentials, or knowledge and skills based on the current associate. List any special education required for this position.
EDUCATION:
High school diploma or GED
YEARS OF EXPERIENCE:
A minimum of 2 years of retail experience.
REQUIRED SKILLS AND KNOWLEDGE:
Must have performance appraisals documenting the following:
- A work history of qualitative consistency, productivity and appropriate interdependence.
- A work history of initiative, motivation and flexibility.
- A work history of above average quality, quantity and knowledge of work.
- A work history of above average attendance and reliability.
LICENSES & CERTIFICATIONS:
The person has passed an examination approved by the Ohio State Board of Pharmacy, PTCB/ CPhT.
Person must register as Technician in Training with Ohio State Board of Pharmacy, if not currently registered with the Ohio State Board of Pharmacy. Upon completion of training period the person must complete registration as Certified Technician with the Ohio State Board of Pharmacy. The person must keep active certification with the Ohio State Board of Pharmacy.
