04/03 Madhulika
HR at RxAdvance PBM India Pvt Ltd.

Views:130 Applications:1 Rec. Actions:Recruiter Actions:1

Pharma Technician - Clinical Data Management (1-5 yrs)

Noida Job Code: 9442

Job Description:

- BPharma/ MPharma mandatory

- Rotational shifts

- Preparing pre-authorization decision trees from established pre-authorization guidelines.

- Accurately entre required information data (non-clinical and structure clinical data) into computer database.

- Review structured clinical data matching it against specified medical terms and diagnoses or procedure codes (without the need for interpretation) and follow established procedure for authorizing request or referring request for further review.

- Actively support departmental and corporate strategic plans and ensure successful implementation.

- Conduct initial clinical review for drug utilization management requests using the established clinical review criteria.

- Manage faxes and ePAs related to pharmacy prior authorizations.

- Refers cases requiring clinical review to a Pharmacist or Medical Director.

- Enter and document coverage determination request decision into the PBM system.

- Identifies problems in process/procedures or services and makes recommendations for improvements.

- Familiarity with medical terminology or willingness to learn.

- Performs additional tasks as assigned.

- Attends required training on an annual basis.

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