Express Scripts Prior Authorization Jobs in Cleveland, OH

**This position is eligible for a sign-on bonus of up to $2,500

Join Cleveland Clinic's Main Campus where research and surgery are advanced, technology is leading-edge, patient care is world class and caregivers are family. Here, you will work alongside a passionate and dedicated team, receive endless support and appreciation, and build a rewarding career with one of the most respected healthcare organizations in the world.

The Pharmacy Technician - Medication Access supports both inpatient and ambulatory care by helping patients overcome medication access and insurance barriers throughout their hospital stay. This highly collaborative, patient-focused role is primarily clinical in nature and involves working closely with physicians, nurses, pharmacists, care coordinators, and patients across Main Campus. Caregivers spend approximately 75% of their time rounding on inpatient units, completing medication histories, verifying insurance coverage, resolving prior authorization and medication access issues, coordinating discharge medication plans, and delivering medications to the bedside. By monitoring patient admissions, identifying financial and coverage barriers, and partnering with the care team to optimize medication plans, this role plays a critical part in ensuring timely access to medications, supporting safe transitions of care, and improving the overall patient experience. Retail, ambulatory, or mail-order pharmacy experience and strong medication knowledge are highly beneficial in this fast-paced, team-oriented environment.

A caregiver in this position will work Sunday to Saturday on shifts of 4 10's from 8:00am to 6:00pm. Weekend rotations occur every 4th weekend and holidays required will be 1-2 per year on rotation as well.

A caregiver who excels in this role will:

• Communicate directly with patients and caregivers while performing technical functions within the assigned work area to ensuretimelyandaccurateprocurement of prescriptions and documentation within the electronic medical record whenrequired.

• Identifypotential medication-related access problems andworkwith patients and the multi-disciplinary team to solve these problems in an efficient and patient-centered manner.

• Coordinate education, bedside medication delivery, and medication payment.

• Assistwith the development and implementation ofpolicies andprocedures to ensure a seamless medication-related procurement process for patients.

• Work with the pharmacy leadership teams toidentifyareas of opportunity for improved patient experience.

• Assistmanager in creating,implementingandmonitoringquality control programs in assignedarea.

• Conduct third partypriorauthorization requests when needed.

• Monitorprogram performance, including patient volumes served and patient experience indicators, serving as a valued resource toidentifydischarge prescription coverage issues andassistin their resolution.

• Complete medication histories or other transitional care activities as assigned per location.

Minimum qualifications for the ideal future caregiver include:

• High School Diploma/GED

• Six months of related experience OR completion of aPharmacyTechnician Program

Must meet all of the following license and certification combination requirements at the time of application:

• Must hold an active registration as a Registered Pharmacy Technician through the Ohio Board of Pharmacy (OBOP).

Please note:A status as a Pharmacy Technician Trainee with OBOP does not qualify for this role. However, please visit the apprenticeship program to express interest: https://talentcommunity.clevelandclinic.org/campaign/apprentiship-programs/)

• It is required, within 18 months from the date of hire: Must obtain a national certification as a Certified Pharmacy Technician (CPhT) certification through the Pharmacy Technician Certification Board (PTCB) or the National Healthcare Association (NHA) AND Registration as a Certified Pharmacy Technician with the Ohio Board of Pharmacy

Preferred qualifications for the ideal future caregiver include:

• Experience dealing with third party insurance and prior authorization process
• Completion of a formal pharmacy technician training program

Physical Requirements:

• Typical physical demands include ability to perform the job while standing and walking for prolonged times, approximately 75% of shift and continuously for extended periods of time.
• Manual dexterity sufficient to perform computer and dispensing functions of the job.
• Ability to lift up to 20 pounds.
• Position often includes reaching, stretching, stooping, climbing steps and sitting.

Personal Protective Equipment:

• Follows standard precautions using personal protective equipment as required.

Pay Range

Minimum hourly: $22.50

Maximum hourly: $32.00

The pay range displayed on this job posting reflects the anticipated range for new hires. A successful candidate's actual compensation will be determined after taking factors into consideration such as the candidate's work history, experience, skill set and education. The pay range displayed does not include any applicable pay practices (e.g., shift differentials, overtime, etc.). The pay range does not include the value of Cleveland Clinic's benefits package (e.g., healthcare, dental and vision benefits, retirement savings account contributions, etc.).