ࡱ> #"A 7bjbjo>o> B2 T T) & & 8T 4 (T(|||| '''''''$$*,''||H'R||''q  |Y,HF u''0 ( ,^-L^- ^- '' (^-& F:  BULLETIN 2017-21 March 27, 2017 U.S. Department of Labor Employment and Training Administration, Office of Apprenticeship (OA) Washington, D.C. 20210Distribution: A-541 Hdqtrs A-544 All Field Tech A-547 SD+RD+SAA+; Lab.Com  INCLUDEPICTURE "cid:image001.jpg@01D100EC.972066E0" \* MERGEFORMAT Subject: Revision to an Existing Apprenticeable Occupation: Pharmacy Technician Code: 200.1 Symbols: DPQSP/DMcAction: Immediate PURPOSE: To inform the staff of OA, State Apprenticeship Agencies (SAA), Registered Apprenticeship program sponsors, and other Registered Apprenticeship partners of a revision to an existing apprenticeable occupation: Pharmacy Technician O*NET-SOC Code: 29-2052.00 RAPIDS Code: 0844CB Term: Competency-based Type of Training: Competency-based BACKGROUND: The revised Pharmacy Technician occupation was submitted by Mr. Ernest DuPont, Senior Director, Workforce Initiatives, on behalf of CVS Health. The new revision entails adding positions to the Pharmacy Technician occupation for the Pharmacy Benefits Management business unit. Specifically, the positions of Technician I, II, and III (Level I, II, III) for Prior Authorization have been added. The addition details the competencies and learning courses required for each position in the Pharmacy Benefits Management Call Center. The revised Pharmacy Technician will be added to the List of Occupations Recognized as Apprenticeable by OA when the list is reissued. A suggested Work Process Schedule and Related Instruction Outline are attached. If you have any questions, please contact Mr. Doug McPherson, Apprenticeship and Training Representative, Division of Program Quality, Standards and Policy at (202) 693-3783. ACTION: OA staff should familiarize themselves with this bulletin and the attached Work Process Schedule and Related Instruction Outline, as a source for developing apprenticeship standards and/or providing technical assistance. NOTE: This bulletin is being sent via electronic mail. 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" # $ % & ' ( ) * + , - . / 0 1 2 3 4 5 6 7 8 9 : ; < = > ? @ A B C D E F G H I J K L M N O P Q R S T U V W X Y Z [ \ ] ^   !"$&'(*+,./0  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q@ Oh+'0  8 D P \hpx      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~ wbjbjo>o>  T T(N BBBBBD b  (. . . v!v!v!$4Bv!v!v!v!v!4BB. . HI.$.$.$v!B. B. .$v!.$.$f 0. p"~_0L )#@)|)Br.$v!v!v!44.$v!v!v!v!v!v!v!)v!v!v!v!v!v!v!v!v! :  WORK PROCESS SCHEDULE PHARMACY TECHNICIAN, RETAIL STORE (Existing Title: Pharmacist Assistant) (Pharmacy Technician, Level I) O*NET-SOC CODE: 29-2052.00 RAPIDS CODE: 0844CB Pharmacy Technician New Hire or Pharmacy Technician Apprentice Understand the culture at CVS - how we do things and what's important to us - as well as CVS's Service standards - what excellent service looks like and how to deliver it Understand key responsibilities of CVS Caremark colleagues and provides appropriate guidance for colleagues looking for the right solutions to ethical questions or issues Understand company policies, procedures and resources Be compliant with laws regarding: Minor employee work restrictions Americans with Disabilities Act Sale of age restricted products and money orders/money grams HIPAA (non-pharmacy employees) Third Party billing (OIG) Understand the value and benefits of the ExtraCare Program, including how to properly convey the benefits of the program to the customer Process basic register transactions and how to provide good customer service at the checkout Understand the procedures for processing customer refunds and the customer skills involved in successfully managing these more complex transactions Information Security and Confidentiality Training: Define the different types of confidential information in your workplace Understand why it is important to protect confidential information Be familiar with the best practices on safeguarding confidential information Be knowledgeable on additional security measures you can take to protect confidential information Understand your responsibilities related to the privacy and security of confidential information Preventing Money Laundering: Pharmacy Version: Define money laundering Identify and know where to communicate suspicious activity, including fraud Comply with company policy and limits surrounding prepaid products Pseudoephedrine/Ephedrine (PSE/E) Training: Recognize the dangers of PSE/E Comply with PSE/E legal requirements and CVS/pharmacy policies Manage the receiving, merchandising and sale of PSE/E Recognize and respond suspicious activity with PSE/E Handle challenging PSE/E situations Recognize the importance of the MethCheck Point of Sale (POS) system ExtraCare Pharmacy & Health Rewards: Recognize the purpose of the ExtraCare Pharmacy & Health Rewards program Explain earnings and rewards for ExtraCare Pharmacy & Health Rewards program to patients Enroll a customer into the ExtraCare Pharmacy & Health Rewards program Explain the HIPAA Authorization to patients Refer customer questions to www.CVS.com/rxrewards or to the program brochure Pharmacy Basics Introduction to Pharmacy: Describe how the CVS/pharmacy workflow helps to ensure exceptional customer service and patient safety Explain the roles and responsibilities of each of the five workstations Identify the tools that you will use to manage the workflow Define how quality assurance is woven into each step in the prescription filling process Describe the queues used to manage the workflow Log on to the RxConnect System and obtain User Credentials Navigate the RxConnect System Use the information provided on the patient header and profile to process prescriptions Complete the steps to reprint a prescription label Corporate Integrity Agreement Covered Person Training: Describe the Corporate Integrity Agreement (CIA) Identify the components of the CVS Caremark Compliance and Integrity Program Discuss how our Code of Conduct standards should be applied in your everyday interactions Explain the penalties and fines for non-compliance Medicare Part D Fraud Waste and Abuse (FWA): Know what the Medicare Part D prescription drug benefit is Describe the laws and regulations governing the benefit Understand the areas that are at risk for fraud, waste, and abuse Recognize your responsibility to report potential FWA List organization and contact information Pharmacy Basics Workbook: Describe key information of medication stock bottle Identify various types of medication dosage forms Recognize the elements of prescription labels Recognize medication schedules Complete Action Notes correctly Identify communication vehicles used in the pharmacy Foundations of Pharmacy: Demonstrate a deeper understanding of the skills and knowledge taught in previous Pharmacy Basic courses Demonstrate positive and effective communication skills Demonstrate extraordinary customer service techniques Identify and apply quality and safety procedures Pick-up: Introduction to Pick-up: Identify the steps involved in the pick-up interaction Explain where prescriptions are stored and the steps to take when you cannot locate a prescription Describe the procedures used when customers pick-up refrigerated or reconstituted products Recognize and explain the importance of ensuring a positive interaction at Pick-up Complete the steps to check a prescriptions current status Foundations of Pick-up: Demonstrate the steps in the Pick-up interaction and make the Offer to Counsel Determine which customer questions you can address and which you need to refer to a Pharmacist Address problems when dealing with difficult customers questions Locate over-the-counter (OTC) items Effectively assist customers who are waiting for prescriptions Identify the procedure for handling restricted products Pick-up on-the-job learning: Perform the Pick-up procedures according to CVS standards Respond appropriately to customer requests Perform basic maintenance tasks at the Pick-up workstation Provide exceptional customer service to customers at the Pick-up workstation Drive-Thru: Introduction to Drive-thru: Assist a customer who is picking up a prescription order at Drive-thru Accept new prescription at Drive-thru Accept refill prescription at Drive-thru Drive-thru on-the-job learning: Perform the Drive-thru procedures according to CVS standards Operate the Drive-thru window Understand the standards for managing Drive-thru traffic Provide exceptional customer service to customers at the Drive-thru workstation Production: Introduction to Production: Identify the steps involved in Production Explain how quality and safety are embedded into each step at Production Process a prescription through Production Process a prescription refill Complete the steps to calculate drug price Foundations of Production: Demonstrate a understanding of the Production workflow and why each step is important Demonstrate counting best practices, including working with penicillin and sulfa products Demonstrate proper labeling and prescription assembly tasks Recognize reconstitutables and demonstrate an awareness of basic preparations Complete electronic action notes to ensure proper and complete information is conveyed to customers Provide exceptional service skills when assisting customers on the telephone ScriptPro Overview for New Hires*: Differentiate between Specialist and General user job responsibilities Recognize the purpose and general uses of ScriptPro Demonstrate ability to locate and interpret data on ScriptPro software Verify automatically dispensed prescriptions using ScriptPro Perform manual robot operations Process exceptions from the Pending Work List Perform basic maintenance tasks with the ScriptPro robot *The ScriptPro course is required of those team members from a Store with a ScriptPro machine Production on-the-job learning: Perform the production procedures according to CVS standards Satisfy customer refill requests Respond to customer questions or refer as appropriate Perform basic maintenance tasks at the production workstation Provide exceptional customer service to customers on the telephone while at the production workstation Inventory Management: Introduction to Inventory Management: Identify inventory management processes at CVS/pharmacy Identify the tools and resources available to support pharmacy staff in completing inventory management tasks Explain how inventory management practices contribute to order accuracy and patient satisfaction Describe how daily Cycle Counting contributes to improved accuracy of Balance on Hand (BOH) Identify methods of preparing the pharmacy for Out of Stock scans Identify tasks that are included as part of label maintenance Describe the process of reviewing a Warehouse order Describe the process of reviewing and completing an Outside Vender order Foundations of Inventory Management: Explain key inventory management terms and processes as described in the Introduction to Inventory Management web-based course Differentiate between System Generated and Store Initiated Cycle Counts Recognize when there is a need for a Store Initiated Cycle Count Describe the processes involved in preparing the pharmacy for an Out of Stock Scan Analyze order reports for both Warehouse and Outside Vendor (OV) orders Identify reasons to modify Balance on Order (BOO) for both Warehouse and OV orders Describe the process of checking in both Warehouse and OV deliveries Inventory Management on-the-job learning and Outside Vendor Orders: Practice Complete a Cycle Count Complete an Out of Stock Scan Review the AIMRx Order Detail report Complete an Outside Vendor order Receive a CVS Warehouse deliver Receive an Outside Vendor delivery Receive a Drop Shipment Process the new items report Process the discontinued items report Drop-Off: Introduction to Drop-off: Accept a new prescription at Drop-off Accept a refill prescription at Drop-off Add a patient in the RxConnect system Edit a patients information in the RxConnect system Effectively manage prescription requests in the RxConnect system Third Party Plans and Cards: Recognize Third Party Plans Identify the basics of billing federal/state funded Third Party Plans Recognize the components of Third Party Cards Medicare Part B: Understand the basics of Medicare B Know the expectations of CVS as a Medicare Provider Understand the expectations of you, as an employee, in processing Medicare claims Identify available references Foundations of Drop-off: Explain the responsibilities of the Drop-off Workstation Demonstrate the steps in the Drop-off interaction Identify tasks in the Drop-off interaction that ensure quality and safety Know the components of a valid prescription Convert equivalent measurements for inhalers, ear and eye drops, insulin, and liquids Discuss the regulations that affect controlled substances Identify and process compound prescriptions Review the Customer Service Initiative (CSI) and how it benefits our patients Know the benefits of flavoring medications for our patients and how to promote Identify common types of Third Party rejections and the correct action to take to resolve the rejection Resolve Third Party rejections while communicating with customers Recognize unique Third Party Plans, such as Medicaid, Medicare Parts B and D, and know the requirements for processing claims through these plans Perform Drop-off Best Practices Advanced Drop-off: Complete data entry for new prescriptions Scan a prescription hardcopy Process prescriptions with insufficient inventory Edit a prescription Delete, inactivate, and place prescriptions on hold Advanced Drop-off: Maintain patient allergy information in the pharmacy computer system Interpret prescriptions and quantity dispensed, including Dispense as Written (DAW) codes Know what Coordination of Benefits is and how to apply it in the pharmacy Drug Enforcement Administration and Pharmacy Regulatory Training: Policies and requirements regarding controlled substances The importance of verifying that each prescription is valid Ways to identify forged and altered prescriptions Dispensing guidelines for narcotic drugs Recordkeeping requirements for controlled substances Diversion and diversion trends How to report thefts and losses of controlled substances Drop-off on-the-job learning: Perform the Drop-off procedures according to CVS standards Respond appropriately to customer requests Perform basic maintenance tasks at the Drop-off workstation Provide exceptional customer service to customers at the Drop-off workstation Inventory Management Advanced: Waiting Bin Maintenance: Complete daily Return to Stock (RTS) Complete monthly Waiting Bin Physical Inventory Advanced Inventory Management: Perform Overstock Returns Perform Capital returns (outdates, damages and recalls) Perform Inter-store Medication Transfer ScriptPro Procedures for Specalists*: Recognize the importance of the Specialist responsibilities Identify location of ScriptPro door keys and restrict access to Specialists only Maintain accurate level of operator credentials for all pharmacy staff in ScriptPro Identify replenishment and Return to Stock (RTS) procedures that only a Specialists is authorized to perform Maintain cells and various hardware components within ScriptPro cabinet *The ScriptPro course is required of those team members from a Store with a ScriptPro machine Advanced Inventory Management on-the-job learning: Process non-saleable returns monthly Use the No Sales Movement Report to identify and process Warehouse returns Access the Inventory Tracking Report Complete all RTS procedures Complete the Waiting Bin Physical Inventory Advanced Patient Care Preparation: Opening an Effective Patient Care Conversation: Consider the patients point of view when initiating a conversation Proactively answer some of a patients asked questions Effectively open a conversation RELATED INSTRUCTION OUTLINE PHARMACY TECHNICIAN, RETAIL STORE (Existing Title: Pharmacist Assistant) (Pharmacy Technician, Level I) O*NET-SOC CODE: 29-2052.00 RAPIDS CODE: 0844CB Code Course Name Approximate Hours Pharmacy Technician 130 200580Opening an Effective Patient Care Conversation204010Pharmacy Basics204020Foundations of Pharmacy204040Foundations of Pick-up204045Pick-Up On-the-Job Learning (OJL)204060Foundations of Production204065Production On-the-Job Learning (OJL)204111Drive-Thru Workstation On-the-Job Learning (OJL)204130Foundations of Inventory Management204140Inventory Management On-the-Job Learning204141Outside Vendor Orders: Practice204150Third Party Plans and Cards204170Foundations of Drop-off204175Advanced Drop-off (Instructor Led Training or ILT)204180Drop-off On-the-Job Learning (OJL)204190Introduction to Inventory Management204230Waiting Bin Maintenance204240Advanced Inventory Management204250Advanced Inventory Management On-the-Job Learning (OJL)206000Introduction to Pharmacy206010Introduction to Pick-up206020Introduction to Production206030Introduction to Drive-thru206040Introduction to Drop-off206045Advanced Drop-off Web-Based Training208001ExtraCare Pharmacy & Health Rewards240400Medicare D: Prescritpion Plans269050iPLEDGE REMS Program Training for Pharmacy Support Staff290357Safe Production and Production Safety Zone Video Acknowledgement300500Professional Practices Quality Assurance Standards300805myStore Health Accepting Prescriptions400100myStore - New Colleague Orientation400301Register Basics400302Customer Refunds400400Introduction to ExtraCare540500Medicare Part B Retail Pharmacy Training800007CVS Health Code of Conduct Training800008CVS Health Employee Handbook800107New Colleague Compliance Training800121CVS Health - Firewall Training800141Bi-Annual Training: Pharmacy Technician/Pharmacy Tech Apprentices Version800143PSE/E Training800161Recognizing and Preventing Workplace Violence800164Safety General Awareness and Emergency Procedures Plan Training800186Preventing Money Laundering: Pharmacy Version800273Privacy Training - Level 3800302Security Awareness Training800305Arbitration of Workplace Legal Disputes800681DEA & Pharmacy Regulatory Training for Pharmacy Support Staff WORK PROCESS SCHEDULE PHARMACY TECHNICIAN, RETAIL STORE (Existing Title: Pharmacist Assistant) (Lead Technician, Level II) O*NET-SOC CODE: 29-2052.00 RAPIDS CODE: 0844CB Lead Technician Pharmacy Technician Certification Boards (PTCB) National Certification To become a Lead Technician, the apprentice must prepare and take the PTCB exam to obtain national certification. The apprentice will take PTCB prep courses to develop competencies that build on the Pharmacy Technician curriculum Regulations, Terminology, and Pharmacology: Identify pharmacy laws and regulating bodies Understand vocabulary used in the medical and pharmaceutical fields Accurately and completely process prescriptions Understand therapeutic information for top 200 medications Identify drug classifications Identify common drug interactions Hospital Pharmacy: Understand inventory management Identify information required for medication orders Identify and describe the different routes of administration Understand proper compounding procedures according to U.S. Pharmacopeia (USP) Understand procedures involved in Investigational Drug Studies Identify and describe commonly used pharmaceutical references Calculations in the Pharmacy Practice Setting: Understand basic mathematical skills Understand relationships between different measurement systems Complete pharmacy calculations including dosage calculations, flow rates, percent solutions, dilution, alligations, and childrens dosing Team Building in the Pharmacy Understand four leadership styles Understand characteristics of effective team Understand phases of team development Be able to motivate team members Maximizing Service through Conflict Resolution Define discord, disagreement, and conflict Identify primary types of workplace discord Understand conditions leading to unhealthy discord Understand customer complaints and impact on the business Be able to resolve discord among employees Delegation of Pharmacy Tasks Define delegation Articulate benefits of delegation Identify and overcome obstacles to delegation Understand characteristics of good delegation Apply four-step delegation model Refunds and Coupons Outside Sale Perform various types of returns, refunds or exchanges Provide appropriate form of payment back to customer Exercise management discretion on refunds Reduce companys liability to fraudulent refunds Provide guidance to team on handling questionable returns while balancing customer service with loss prevention Manager Voids Recognize and accurately process manager voids Provide quick and courteous customer service RELATED INSTRUCTION OUTLINE PHARMACY TECHNICIAN, RETAIL STORE (Existing Title: Pharmacist Assistant) (Lead Technician, Level II) O*NET-SOC CODE: 29-2052.00 RAPIDS CODE: 0844CB Code Course Name Approximate Hours Lead Technician 45 203050Pharmacy Technician Certification Boards -PTCB- National Certification203061PTCB Study Session: One (Instructor-Led)203062PTCB Study Session: Two (Instructor-Led)203063PTCB Study Session: Three (Instructor-Led)203064PTCB Study Session: Four (Instructor-Led)203065PTCB Orientation Session (Instructor-Led)92110045Pharmacy Technician Certification Board (PTCB) - Session 1 (WBT/Online)92110050Pharmacy Technician Certification Board (PTCB) - Session 2 (WBT/Online)92110055Pharmacy Technician Certification Board (PTCB) - Session 3 (WBT/Online)92110060Pharmacy Technician Certification Board (PTCB) - Session 4 (WBT/Online)250530Team Building in the Pharmacy250540Maximizing Service Through Conflict Resolution250620Delegation of Pharmacy Tasks500700SMD - Refunds and Coupons Outside Sale500800SMD - Manager Voids WORK PROCESS SCHEDULE PHARMACY TECHNICIAN, PHARMACY BENEFITS MANAGEMENT (Existing Title: Pharmacist Assistant) (Technician I, Level I) O*NET-SOC CODE: 29-2052.00 RAPIDS CODE: 0844CB Technician I Pharmacy Benefit Management (PBM) Structure and Organization: The apprentice demonstrates an appropriate working knowledge and understanding of the pharmacy benefit manager, its role and organization: Understand the organization of the PBM Understand the relationships and duties of the pharmacists, technicians and support personnel Understand the relationships and supervisory structure of the PBM Understand how to comply with PBM guidelines and work place ethics Maintain patient and client confidentiality and explain the implications of any violation PBM Structure and Operations: The apprentice demonstrates an appropriate knowledge and understanding of the duties and responsibilities of his/her position including standards of ethics governing practice Understand how to comply with federal, state, and local laws related to pharmacy benefits management Understand the primary job responsibilities and duties of the pharmacist Understand the primary job responsibilities and duties of the technician Understand the relationship of the duties between the pharmacist and the technician Understand the relationships of the pharmacy benefit manager including pharmacist with doctor, patient and technician, and technician with pharmacist, doctor and patient Differentiate clearly when "a decision requiring a pharmacist's judgment" is needed Communicate accurately, efficiently, and appropriately with patients and medical personnel on the telephone Communicate clearly in writing Demonstrate basic computer and keyboarding skills and the ability to learn PBM software Technical Vocabulary: The apprentice demonstrates an appropriate knowledge and understanding of pharmaceutical-medical terms, abbreviations, and symbols commonly used in the administration of pharmacy benefits Identify and classify drugs correctly Abbreviate and spell medical and pharmaceutical terms accurately Demonstrate a working knowledge of researching information regarding medications Knowledge of Drugs and Medications: The apprentice demonstrates a working knowledge of drugs and drug classes evaluated in the prior authorization and appeals processes. Demonstrate a working knowledge of the top drugs requiring prior authorization Differentiate accurately between generic and brand name drugs Computation Skills: The apprentice demonstrates the ability to carry out the calculations required for accurately identifying insurance parameters for medications. Translate between the apothecary, metric and household measurements accurately Demonstrate a working knowledge of addition, subtraction, multiplication and division in the metric and apothecary systems Calculate billing prices accurately using test claim functions Drug Dosage, Administration, and Forms: The apprentice demonstrates a working knowledge of drug dosages, rules of administration and dosage forms as necessary for understanding and researching insurance plan adjudication Identify standard drug dosages for various drug classes Recognize various forms of drugs differentiated in adjudication including tablets, capsules, solutions, suspensions, ointments, powders, injections, and suppositories Recognize the rationales for drug use in prior authorization criteria, including preventive, curative, restorative and limiting disease processes Recognize the relationships between patient variables and drug therapy Understand how to explain the various routes of administration including oral, sublingual, buccal, inhalation, and rectal Demonstrate a working knowledge of needle and syringe sizes and uses Prescription Research: The apprentice demonstrates the ability to perform the manipulative and record-keeping functions associated with initiating and working prior authorizations and appeals. Demonstrate proficiency in accessing and maintaining records electronically Demonstrate satisfactory customer skills such as the ability to listen and interpret internal and external customers needs Communicate accurately with customers and demonstrate empathy Workplace Behaviors: The apprentice must demonstrate workplace behaviors that contribute to his/her success and that of the PBM. Apply classroom instruction to PBM operations Demonstrate an ability to learn and apply new concepts Take initiative in seeking to contribute to the work of the PBM and increase his/her learning opportunities Exhibit quality meeting minimum expectations Produce quantity of work meeting minimum expectations Maintain his/her schedule in timely manner Demonstrate good communication skills Demonstrate good judgment Exhibit a positive and cooperative attitude RELATED INSTRUCTION OUTLINE PHARMACY TECHNICIAN, PHARMACY BENEFITS MANAGEMENT (Existing Title: Pharmacist Assistant) (Technician I, Level I) O*NET-SOC CODE: 29-2052.00 RAPIDS CODE: 0844CB Code Course Name Approximate Hours Technician I 146 203050 Pharmacy Technician Certification Boards - PTCB National Certification 92110045Pharmacy Technician Certification Board (PTCB) - Session 1 (WBT/Online)92110050Pharmacy Technician Certification Board (PTCB) - Session 2 (WBT/Online)92110055Pharmacy Technician Certification Board (PTCB) - Session 3 (WBT/Online)92110060Pharmacy Technician Certification Board (PTCB) - Session 4 (WBT/Online)300015 Business Overview - CVS Caremark 94000338 Clinical Services - Famous for Service - Dedicated - Individual Contributor 92000507 CAS Web - Core Functions 94000376 Prior Authorization (PA) Escalation Consultation 61000056 Salesforce.com Prior Authorization Workflow - CAS 206050 Introduction to Quality Assurance SS03895 Customer Service over the Phone SS04452 Building Trust 300720 Behavioral Styles SS01685 Making Telephone Calls Count 600561 Different Like You - Appreciating Diversity in the 21st Century Workbook Top 100 Drugs for Prior Authorization in the PBM Classroom Detailed Review of Processes & Systems (see below for three-week curriculum) Week One, Virtual Classroom Day One SessionsWelcome to CVS Caremark Using Adobe Connect Contingent eLearning Privacy Training Level 3 #800273 4A: Intro to Utilization Management: What is a PBM? 4B: Intro to Utilization Management: What is UM? The PA Phone Process Soft Skills Session AFamous For Service Behaviors Protecting PHI Clinical Encounter Day Two SessionsBacking Up the Hard Drive-Review Protecting PHI Introduction to SystemsCAS Introduction to SystemsPeopleSafe Introduction to SystemsRxClaim Observation Introduction to Research Method Contingent eLearningRecognizing and Preventing Workplace Violence #800161 Parking Lot Q&A and Daily Summary Day Three SessionsBack Up the Hard DriveReview Systems & Research Method Using the Systems--Research Exercise Using the SystemsDebrief PA Process Demo Using RxSource & The Hub Phone Zone #1 Contingent eLearning: Security Awareness Training #800302 Avaya Phone Systems Parking Lot Q&A Day Four SessionsInform & EngageRxSource Back Up the Hard DriveReview the PA Process Assessment: Research Method and PA Process Observation Screen Sharing tutorial Trainee Navigation and PA Work with Screen Sharing Parking Lot Q&A Day Five SessionsInform & EngageRxSource GST and Formulary Programs Formulary (FA-PA or FA-EXC) Advanced Control Formulary (ACF) Value Formulary (VF) Custom Medical Necessity Program Value Utilization Management Processing Various UM Program PA Requests (individual screen sharing fax work) Parking Lot and Week in Review  Week Two, Virtual Classroom Day One SessionsInform and EngageRxSource Back Up the Hard DriveGST and Formulary Programs Review Trigger Forms, Refaxing, and Non-PA Scenarios Working Faxes Via Screen Sharing (or Paired Work on the Floor) Quality Assurance Submitting Errors Working Faxes (paired on the floor) Parking Lot Q&A Day Two SessionsInform & EngageRxSource Back Up the Hard Drive-- Trigger Forms, Refaxing, and Non-PA Scenarios Performance Guarantees and Client-Specific Processes Client Specific Process Contingent eLearningCVS Health Firewall Training #800121 Client Specific ProcessFallon Compound PA Process Working Faxes (paired on the floor) Phone Zone # Parking Lot Q&A Day Three SessionsInform & EngageRxSource Exchange PA Process Client Specific ProcessUMWA Back Up the Hard DriveClient Specific Processes Working Faxes Individually on the floor DebriefIndividual Fax Work Phone Zone # Parking Lot Q&A Day Four SessionsInform & EngageRxSource Contingent eLearning Code of Conduct #800007 UM Program Review Client-Specific Process Review Working Faxes Individually on the floor DebriefIndividual Fax Work Clinical Encounter Parking Lot Q&A Day Five SessionsInform & EngageRxSource ReviewResearch Method ReviewPA Process ReviewUM Process Review--Client-Specific Processes Comprehensive Assessment: Systems, Research, Process, Programs and Clients  Week Three, Classroom Day One SessionsBack up the Hard Drive Review UM and Client Specifics 2A: Retake Assessment, if needed 2B: Refresh Navigating PA Process Individually Avaya Phone System Review Inbound Call Process Handling Phone Requests Soft Skills and Call Handling Session B Parking Lot Q&ADay Two SessionsBack up the Hard Drive Review Inbound Call Process Phone Zone Evaluate Exceeds Inbound Call Clinical Encounter Common PA Drugs Activity Role Playing Debrief Role Playing Clinical Encounter Diagnosis and Medical Terminology Live Calls (With Partner or Individually) Debrief Live Calls Parking Lot Q&ADay Three SessionsBack up the Hard Drive Review Escalated Calls Activity Role Play Challenging Calls Debrief - Role Play Clinical Encounter - Common PA Drugs Live Calls (Individually) Debrief Live Calls Phone Zone: Evaluate Exceeds Inbound Call Parking Lot Q&ADay Four SessionsBack up the Hard Drive Call Expectations Review Quality & Call Expectations Review Common Quality Errors Review Error Submission Process Live Calls (Individually) Debrief Live Calls Clinical Encounter - Diagnosis and Medical Terminology Parking Lot Q&ADay Five SessionsInform & Engage - RxSource Phone Zone Evaluate Exceeds Inbound Call Live Calls Individuals Debrief Live Calls Inbound Call Wrap Up Review Parking Lot Q&A Start PRC Process WORK PROCESS SCHEDULE PHARMACY TECHNICIAN, PHARMACY BENEFITS MANAGEMENT (Existing Title: Pharmacist Assistant) (Technician II, Level II) O*NET-SOC CODE: 29-2052.00 RAPIDS CODE: 0844CB Technician II A. Client-Based Knowledge: The apprentice demonstrates appropriate knowledge and mastery of PBM products and services for clients. Differentiate between various clients, functions, and business teams within the enterprise Understand the different business segments under prior authorization, including Commercial, Aetna, Medicare, Medicaid, Exchange, Exceptions, Specialty, and Appeals Understand the different clients within business segments Understand work instructions and guidance for custom clients Acquire appropriate business acumen to demonstrate understanding and knowledge of business and client segments B. Compliance & Execution: The apprentice is able to comply with a multitude of requirements when processing information for internal and external clients. Understand and apply the departmental, company, state, and federal requirements and regulations Demonstrate a sense of urgency when handling assignments Processes information to ensure accuracy when provided to customers Follow directions, is able to multi-task, and pays attention to details Solve problems and build strong working relationships Identify and communicate operational gaps, quality, set up, and coding issues Adhere to department goals and metrics C. Communications: The apprentice demonstrates enhanced communication and higher-level customer service skills. Communicate well verbally and in writing along with active listening and strong interpersonal skills Customize messages for delivery to broader audiences Communicate client specific information internally and externally Effectively handle calls from internal and external customers, including escalated issues Create, interpret, and manage reports for the department and clients (applies to Commercial and Case Review teams) D. Mentoring: The apprentice demonstrates subject matter expertise about the PBM operations and is able to serve as a mentor to peers. Understand Technician I duties and demonstrate how to perform these duties Assist trainers and supervisors with training of new hires Serve as a Subject Matter Expert (SME) and peer mentor to new hires and incumbents who are at the Technician I level Facilitate collaboration and build consensus among peers Assist technicians with any customer issues on calls and with faxes E. Computer Skills: The apprentice has advanced beyond the basic knowledge of navigating in a PC Windows environment and is proficient in Microsoft Office. Demonstrate advanced computer skills Utilize the internal systems specific to PBM operations Quickly learn new computer applications and database software programs Demonstrate proficient knowledge of Microsoft Office Suite in particular Excel RELATED INSTRUCTION OUTLINE PHARMACY TECHNICIAN, PHARMACY BENEFITS MANAGEMENT (Existing Title: Pharmacist Assistant) (Technician II, Level II) O*NET-SOC CODE: 29-2052.00 RAPIDS CODE: 0844CB Code Course Name Approximate Hours Technician II 22 300600 Embracing Change: An Individual Reflection On Building Commitment To Change SS03680 Interpersonal Communication: Listening Essentials SS04122 Problem Solving: Determining and Building Your Strengths 550034 Diversity, Empowerment and High Performance - Part 1 of 2 5550036 Diversity, Empowerment and High Performance - Part 2 of 2 SS01855 Customer Interactions SS01856 Communication Skills SS01857 Conflict, Stress and Time Management SS02726 Techniques for Improved Time Management SS05065 Professionalism, Business Etiquette, and Personal Accountability SS06021 Creating Workbooks, Worksheets, and Data in Excel 2013 WORK PROCESS SCHEDULE PHARMACY TECHNICIAN, PHARMACY BENEFITS MANAGEMENT (Existing Title: Pharmacist Assistant) (Technician III, Level III) O*NET-SOC CODE: 29-2052.00 RAPIDS CODE: 0844CB Technician III A. Leadership: The apprentice effectively displays leadership in a group environment. Serve as a SME to other technicians on processes and procedures for prior authorization. Resolve operational issues experienced by other technicians (i.e. offering help through the Assist Line) Create a cohesive and productive team atmosphere Acquire support for top down decisions and actions Inspire and motivate colleagues to achieve team goals Resolve team conflicts with finesse Make recommendations for improvement to supervisors Communicate improvements to peers once approved Assist management with the implementation of change Identify skill gaps among the team and report these to supervisors Assist management in up-skilling of coordinators and technicians Provide management with valid and reliable information for staff planning (applies to Case Review team) B. Advanced Communications: The apprentice is able to effectively communicate with patients, clients, colleagues, and senior leadership. Demonstrate the proper use of business communication and etiquette for various audiences, including in emails and instant messages Identify and track prior authorization data and trends for reports Request in-depth reports and perform analysis based on business needs Write clear and concise email messages for broader team distribution Concisely and accurately convey case and prior authorization summaries Work on special projects, research, and assignments C. Resolution: The apprentice exhibits critical thinking skills and is able to provide effective case resolution. Understand the adjudication processes for prior authorization Be accountable and take ownership of case resolution Work independently to resolve complex issues Explain complexities to clients, physicians, and members Consistently overcome objectives in order to reach agreement Efficiently respond to clients on escalated or time-sensitive issues Explain status of a case, adverse decisions, next steps, and alternative options to customers Summarize requests for the development of action plans Process appeal requests RELATED INSTRUCTION OUTLINE PHARMACY TECHNICIAN, PHARMACY BENEFITS MANAGEMENT (Existing Title: Pharmacist Assistant) (Technician III, Level III) O*NET-SOC CODE: 29-2052.00 RAPIDS CODE: 0844CB Code Course Name Approximate Hours Technician III 15 SS02741 Working for Your Inner Boss: Personal Accountability SS03820 Influence and Persuasion SS03878 Getting Results without Authority: Building Relationships and Credibility SS04108 Diversity on the Job: The Importance of Diversity and the Changing Workplace SS04120 Time Management: Avoiding Time Stealers SS04124 Decision Making: The Fundamentals SS04170 Negotiation Essentials: What Is Negotiation? 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