Pharmacy Technician On Site Iwakuni, Japan

Arcetyp LLC is a growing small business that provides a broad range of consulting services to US Federal Government, US Military, and Commercial clients. Services include Management & IT Consulting, Program & Project Management, and Professional & Admin Services.

We accept direct hire candidates only, W2 employee hires. We do not accept 1099 independent consultants. We do not accept staffing firms. We do not accept corp-to-corp (C2C) candidates. We can't sponsor H1B.

Arcetyp LLC is looking for a Pharmacy Technician to support the Government in Japan. This will be an on-site, in-office position with one position located in Iwakuni, Japan.

• The Pharmacy Technician will assist in developing and refining referral management (RM) to support medical management initiatives at the military treatment facility (MTF).

• Assess, monitor and evaluate and assist in processing referrals for authorization. The contractor shall review specialty care referrals for clinical appropriateness, covered benefit, and administrative and medical completeness following MTF, DHA, BUMED guidelines and TRICARE policy.
• The HCW shall input and retrieve patient information for each referral, through the use of various computer systems include Electronic Health Record (EHR), Defense Enrollment Eligibility Reporting System (DEERS) and other work programs that are in use in the Referral Management Center.
• Refer to a physician advisor for clinical review if the HCW and physician cannot reach an agreement on the processing of a referral within one business days. Timelines shall be monitored through computer reporting systems such as Electronic Health Record and TRICARE Reports.
• Elevate referrals to the medical manager, utilization nurse, and physician advisor for higher level of review when there is uncertainty in medical necessity and covered benefit. All referrals for routine continental US care will be elevated to the medical manager and director of medical services.
• Communicate between physician reviewer and the requesting provider in regard to preauthorization.
• Submit monthly, quarterly, and yearly utilization reports using Electronic Health Record and TRICARE Reports. The HCW will report on referral trends, patterns or incidents of under- and/ over- utilization of resources, network leakage, purchased care costs, network care recapture, continuity of care, and customer satisfaction for all beneficiaries. The HCW will discuss patterns and trends with MTF providers and the Directorate of Healthcare Business leadership to educate and improve processes.
  
  The HCW shall present these reports to all medical staff with recommendations for efficient use of resources.
• Evaluate monthly through prospective, concurrent, retrospective review, focused reviews, clinical pathways and clinical practice guidelines for performance outcomes of clinical care. The HCW will review ten defer to network consults per month to determine consult outcome and if clinical practice guidelines were met. If not met, the HCW will develop and implement a plan of action for consult management to ensure clinical practice guidelines are met.
• Identify and communicate all adverse trends and referral management discrepancies in a written report via the chain of command and effectively communicate both verbally and in writing with the requesting physician(s) for clarification and correction. The report is to be submitted when trend/discrepancies identified.
• Manage the referral processing center for all beneficiary categories (Active Duty, Active Duty Family Members, Retirees, and their family member, survivors, Department of Defense Civilians, Contractors) of patient clinical referrals and care authorizations to health care specialists in either the direct care or purchased care systems.
• Provide departmental, directorate, and command performance improvement processes commensurate with this position. The HCW will be responsible for participating in monthly education programs, quality assurance functions and process action teams to improve the operations of the referral management center.
• Referral management services will be performed in a…