Verifies member information and inputs data for the pharmacists. Educates members on pharmacy based rules related to prescriptions and medication resources or assistance programs. Processes prior authorization requests from physicians offices and ensures compliance with Medicare requirements; informs relevant parties of all prior authorization determinations. Provides resolution to grievances and appeals issues. Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits. Generates reports relating to rebates, physician utilization, Beers Criteria, Reliance members, and other ad hoc reports. Maintains record keeping of prior authorizations, rebates, and monthly reports. Minimum Requirements: Requires H. S. diploma or equivalent and minimum of 1 year of pharmacy experience; or any combination of education and experience, which would provide an equivalent background. Current State Pharmacy Tech. Certification or National Certification based on applicable state(s) required. Bilingual (Spanish) or multi-language skills required. Must be able to pass a validated language test/assessment. Preferred Skills, Capabilities and Experiences:Good phone etiquette and customer service experience preferred. Experience in pharmacy retail setting preferred. English and Spanish language fluency in both written and verbally is strongly preferred. For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. Job Level:Non-Management Non-Exempt. Workshift: