Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together.
Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.
Moda Health is currently seeking a Pharmacy Prior Authorization Coordinator to join our Pharmacy Department. The position will be responsible for processing pharmacy related prior-authorizations for approval or denial, including entering data into appropriate internal and external systems
- Performs the following tasks under the supervision of a pharmacist in a timely manner: Patient intake. Contacts patients and/or caregivers to schedule a delivery and determine supply needs; picks and packs medical supplies to fill patient orders; accurately uses the computer software to generate a delivery ticket and/or prescription labels; confirms delivery tickets after delivery.
- Assists the clinical pharmacist with the preparation and dispensing of medications and supplies while following the policies and procedures.
- Assists with calibrating equipment, recording, and maintaining pharmacy temperature and cleaning logs.
- Ensures that all pharmacy surfaces, laminar flow hoods and clean room are cleaned per policy & procedure manual.
- Capable of performing basic pharmaceutical calculations in order to obtain correct doses of medications.
- Prepares medications under the supervision of a pharmacist so they are accurately compounded.
- Ensures that a licensed pharmacist properly checks all compounding and packing. Adheres to appropriate safety and quality assurance practices. Complies with state and federal laws.
- Responsible for assisting with product purchasing, inventory and equipment management.
- Orders the correct drug products from the wholesale vendor if requested. Knowledgeable of various vendors and where to get different supplies, medications and clean room needs.
- Verifies, cleans and tests infusion pumps. Assists with tracking infusion pumps and medical equipment utilizing our software.
- Able to maintain confidentiality of patient and proprietary business information. Observes legal and ethical guidelines for safeguarding the confidentiality of patients.
- Team player that can participates in the process for assessing, managing, and reporting medication-related incidents and equipment error and/or failures. Accurately completes QAR forms and forwards them to the clinical pharmacist.
- Willing to assist with the training and supervision of new IV Pharmacy Technicians.
- In all activities, complies with accreditation, legal, regulatory, and safety requirements.
- Participates in on-call responsibilities of the pharmacy department if required.
- Perform other duties as assigned.
If you’re ready to make a difference that matters, we want to hear from you. Because it’s time to discover what’s possible.
Together, we can be more. We can be better.
Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law.
1. Licensed and Certified with Oregon State Board of Pharmacy.
2. One to two years working experience in a pharmacy or health plan in Pharmacy Services department in prior authorization role.
3. Demonstrated working knowledge of medical and pharmaceutical terminology, and computer skills including Microsoft Office products (proficiency with Word and Excel). Must be able and willing to learn a third-party real-time interactive PBM database, where great attention to detail is imperative.
4. Typing proficiency of 40 wpm on a computer keyboard.
5. Willingness to work hours necessary to successfully accomplish assigned tasks.
6. Ability to anticipate needs; consistently meet quality and production standards; maintain a high level of confidentiality; project a professional business image; be flexible and adapt to change; handle stress and pressure; and, multi-task.
7. Good analytical, problem solving, decision making, memory retention, and organizational skills.
8. Excellent verbal, written and interpersonal communication skills including management of the angry physician or health care provider.
9. Preference for fast-paced, production-oriented environment.
10. Must have ability to work well with Commercial, Medicare and Medicaid populations and to resolve pharmacy conflicts in a professional manner.
11. Ability to come to work on time and on a daily basis.