Job Detail

Alignment Health is revolutionizing health care for seniors by leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?

At Alignment Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.

Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time.

By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community.

To perform various clinical pharmacy functions under the direct supervision of the VP of Pharmacy and the Pharmacy Manager. The Pharmacy Technician shall perform assigned department administrative functions that do not require the Pharmacy Managers judgment. Responsible for the administrative and clerical support directly involved with the day to day operations of the multiple programs performed by the department. The Pharmacy Technician reports to the Pharmacy Manager and is responsible for performing assigned tasks to meet AHP HMO and Pharmacy Department goals.

General Duties/Responsibilities:

(May include but are not limited to)

• Assist with the daily operations of the various Pharmacy Department programs, multiple projects and participate in Plan and regulatory agency audits as necessary.
• Ability to make high volume of outbound calls to members, prescribers and pharmacies in regards to the Adherence program.
• Assist members in refilling their medications, and reaching out to the prescriber’s office if a member requires additional refills on their maintenance medications.
• Ability to draft routine reports and correspondence.
• Supports all CMS required oversight processes of PBM including but not limited to: Rebates, Explanation of Benefit reports, Transition Reports, and Part B vs Part D.
• Responds to inquiries from physicians, members, and pharmacies related to formulary and prescription benefits.
• Retrieval of accurate, concise, applicable and timely drug information.
• Interact with Plan's contracted PBM to ensure communications and information to other internal Plan departments as applicable.
• Interact with Plan’s contracted PBM in regards to Prior Authorizations, Overrides and in resolving issues pertaining to member’s medications.
• Ability to make outbound calls to pharmacies and prescribers to resolve prescription issues such as medication requires Prior Authorization, assist retail/mail order pharmacies in resolving third party rejections, and reviewing daily rejections while ensuring we are CMS compliant.
• Interaction with internal plan departments to address pharmacy related issues.
• Work closely with compliance department to make sure Pharmacy Programs meet the criteria established by CMS.
• Ensure all HMO’s members information is kept confidential according to HIPAA.
• Other duties as assigned.

Minimum Experience:

• Basic Computer Skills (Microsoft Outlook, Excel, Word) and related/integrated systems.
• Knowledge of Medicare/Managed Care Plans and/or PBM preferred.
• Education/Licensure: Pharmacy Technician license and or certification preferred
• Other:
• • Bilingual - English/Spanish strongly preferred or English/Chinese (Mandarin preferred) or English/Vietnamese must be able to speak fluently strongly preferred.
  • Excellent verbal & phone communication (customer service) skills.
  • Knowledge of pharmacy and medical nomenclature/terminology, common medication dosages, trade & generics and medication therapy application.
  • Excellent organizational skills with the ability to maintain accurate records collect & maintain data for statistical reporting.
  • Ability to multi-task with minimal direction &
  • Ability to reason, logical thinking & carry out instructions.
  • 2-3 years related experience with minimum one year of experience in generating specific healthcare pharmacy reports and analysis.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
• The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Pay range: $20-24/hr

Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

• DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email careers@ahcusa.com.