Pharmacy Technician

COMPANY OVERVIEW

Zing Health is a tech-enabled insurance company making Medicare Advantage the best it can be for those 65-and-over. Zing Health has a community-based approach that recognizes the importance of the social determinants of health in keeping individuals and communities healthy. Zing Health aims to return the physician and the member to the center of the health care equation. Members receive individualized assistance to make their transition to Zing Health as easy as possible. Zing Health offers members the ability to personalize their plans, access to facilities designed to help them better meet their healthcare needs, and a dedicated care team. For more information on Zing Health, visit www.myzinghealth.com.

Summary Description

Zing Pharmacy Services staff work to ensure that Zing Health members have access to all medically necessary prescription drugs and those drugs are used in a cost-effective, safe manner. The Zing Health Pharmacy Technician is responsible for supporting the development, maintenance, and ongoing oversight for clinical and operational pharmacy programs and processes at Zing Health. 

Essential Functions

Formulary Management

• Responsible for all administrative components of formulary creation, development, and maintenance.   
• Non-clinical subject matter expert (SME) of CCA formularies
• Create, maintain, submit, and post formularies using formulary management tool for all lines of business
• Partner with key stakeholders to provide oversight and monitoring of formulary marketing materials, claims adjudication testing, and participation in weekly PBM calls.
• Support pharmacy operations team in the analysis of monthly and yearly formulary submissions.  
• Conduct scheduled and ad hoc comparisons of competitor drug coverage for all lines of business

Quality Assurance & Regulatory

• Assists Zing Health customer services, network pharmacies, and health plan providers in resolving member prescription claims, prior authorization, appeals or pharmacy services access issues.
• Participate and provide support for internal and government audits.
• Participate in internal work groups as required (e.g. FWA, Member Services)
• Develop and maintain pharmacy operations workflows, job aids, and training materials as required.
• Support resolution of member grievances as needed.
• Act as pharmacy operations liaison with internal Zing departments as designated.
• Develop materials and educate internal departments on pharmacy operations as deemed necessary.
• Participates in the development/administration of programs designed to enhance the utilization of targeted therapeutic drug classification – enhancing Part D STARS outcomes.
• Completes assignments for special projects which may include compiling information, report generation, and maintenance of necessary records and files.
• Follows directions of Pharmacy Leadership, related to day-to-day operations and evolving program management.
• Track and formally respond to pharmacy related inquiries from internal and external stakeholders.
• Proficient at researching and resolving medication issues, using the appropriate reference material, until complete issue resolution.

QUALIFICATIONS AND REQUIREMENTS:

JOB REQUIREMENTS:

Required Qualifications:

• Required Experience
• 2 years experience as a Pharmacy Technician

Education: 

• Required Education
• High School Diploma or GED equivalent
• Preferred Education
• Associates Degree
• Minimum of 2 years of experience in health care or health insurance industry preferred.  
• Experience in retail, hospital, or managed care pharmacy industry required. 
• Experience working with Medicare Parts B and D and/or Medicaid Plans preferred. 

Certifications/Licenses:  

 Required License

• Active Certified Pharmacy Technician (CPh.T) license.

Required Skills:

• Must exhibit an intermediate level of expertise in the following:
• Working knowledge of pharmaceutical managed care, and PBM industries
• Uses pharmacy claim reports to perform audits and quality checks on prior authorizations that are active in the pharmacy claims processor.
• Working knowledge of pharmaceutical claims, language, drug usage, and generic substitution practices.
• Computer skills and working knowledge of Microsoft products, claims processing software, and report generation.
• Ability to learn new software applications.
• Familiarity with Formulary Lists, including common edits and restrictions.

Additional Required Skills:

• Strong knowledge of healthcare delivery
• Excellent Communication skills — Listening, speaking, and writing.
• Personal management skills — Plan and manage multiple assignments and tasks, set priorities, and adapt to changing conditions and work assignments. 
• Teamwork —the ability to work well with one or more groups.
• Interpersonal effectiveness — Relate to co-workers and build relationships with others in the organization.
• Strong work values — Dependability, honesty, and a positive attitude.

Member-centric Impact Statement:

The Clinical ME department ensures that members receive high-quality, evidence-based medical care and interventions. By closely monitoring clinical outcomes and implementing best practices, Clinical ME enhances member satisfaction, encourages retention through improved health outcomes, and supports productivity by reducing preventable complications and hospitalizations. 

Zing Health offers the following benefits:

•  A competitive salary based on the market
•  Medical, Dental, and Vision
•  Employer-Paid Life Insurance
•  Paid Maternal Leave
•  Paid Paternal Leave
•  401(K) match up to 4%
•  Paid-Time-Off
•  Employee Assistance Programs
•  Several supplemental benefits are available, including, but not limited to, Spouse Insurance, Pet Insurance, Critical Illness coverage, ID Protection, etc.

Zing Health is committed to being an Equal Opportunity Employer. This means the company ensures all employment decisions, including hiring, promotion, compensation, and benefits, are made without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other legally protected characteristic. Zing Health strives to create a diverse, inclusive, and respectful workplace, providing equal access and opportunities for all employees and applicants. The organization actively promotes a culture of fairness and non-discrimination, supporting the personal and professional growth of every team member