The Pharmacy Technician is the professional responsible for receiving and processing medical prescriptions. They must serve patients with the highest standards of service and must interact with and assist patients. The Pharmacy Technician must comply with the regulations of their profession and keep their credentials up to date.
Responsibilities:
Assist the pharmacist with dispensing tasks under direct supervision, in accordance with state and federal laws.Assist the pharmacist with tasks in the Pharmacy Department (prescription desk) in accordance with company policies and procedures. Responsible for using the prescription processing system to obtain patient and medication information to process claims to health plans in a timely and efficient manner. Assist new pharmacy technicians in training on prescription operations. Model and promote excellent patient service, a respectful work environment, and teamwork.Requirements:
Associate's degree in Pharmacy TechnicianPharmacy Technician LicenseCertificate of Registration in Pharmacy Technician***Equal Opportunity Employer M/F/V/D***
Requisitos:
- Grado asociado Tecnico de Farmacia
- Licencia de Técnico de Farmacia
- Certificado de Registro
***Equal Opportunity Employer M/F/V/D***
Read LessLocation: Guaynabo, PR
Alivia Specialty Pharmacy Business Excellence Department oversees and handles successful implementations of strategic projects and accurate execution of the data contracts, to contribute to the organization’s growth and its operational development.
At present, the Business Analyst under this business unit, shall:
Develop and execute reporting for Alivia Specialty Pharmacy (ASP).Execute Limited Drug Distribution (LDD) Report testing.Generate work capacity assessments for ASP business units.Responsible for participating in companies must win battle & strategic projects to ensure they are completed in a timely fashion, and in compliance with contract regulations while keeping participants informed throughout the process.Interact with internal ASP employees, Management and Executive team to identify the relevant information needed to execute project tasks, and provide solutions, whether it be providing reports regularly or educating end-users on how to interpret existing reports.Conduct detailed data analysis on data used across ASP business units.Respond to data related inquiries in real-time to support business units and the ASP team.Perform various data analytics in SQL and MS Excel using statistical models or industry accepted toolsRequirements:
A minimum of 3-4 years of work experience in; Computer Sciences; Data Analysis, Reporting, Data Management, Technology Support, are preferred.Intermediate to advanced experience with at least (3) of the following programs, Excel, Power Query, SQL Server, or Power BI, is required.Must be able to communicate effectively (read, speak, and write) in English and Spanish. Must be able to prepare and deliver business presentations with the proper terminology and data.***Equal Opportunity Employer F/M/V/D/S/A***
Read LessLocation: Guaynabo, PR
Alivia Specialty Pharmacy Business Excellence Department oversees and handles successful implementations of strategic projects and accurate execution of the data contracts, to contribute to the organization’s growth and its operational development.
At present, the Business Analyst under this business unit, shall:
Develop and execute reporting for Alivia Specialty Pharmacy (ASP).Execute Limited Drug Distribution (LDD) Report testing.Generate work capacity assessments for ASP business units.Responsible for participating in companies must win battle & strategic projects to ensure they are completed in a timely fashion, and in compliance with contract regulations while keeping participants informed throughout the process.Interact with internal ASP employees, Management and Executive team to identify the relevant information needed to execute project tasks, and provide solutions, whether it be providing reports regularly or educating end-users on how to interpret existing reports.Conduct detailed data analysis on data used across ASP business units.Respond to data related inquiries in real-time to support business units and the ASP team.Perform various data analytics in SQL and MS Excel using statistical models or industry accepted toolsRequirements:
A minimum of 3-4 years of work experience in; Computer Sciences; Data Analysis, Reporting, Data Management, Technology Support, are preferred.Intermediate to advanced experience with at least (3) of the following programs, Excel, Power Query, SQL Server, or Power BI, is required.Must be able to communicate effectively (read, speak, and write) in English and Spanish. Must be able to prepare and deliver business presentations with the proper terminology and data.***Equal Opportunity Employer F/M/V/D/S/A***
The Pharmacy Technician - ASP is a professional in charge of receiving and processing medical prescriptions. They will attend to the patient with the highest standards of service and will interact and assist patients. The Pharmacy Technician - ASP must comply with the regulations of their profession and keep their credentials up to date.
Responsibilities include, but are not limited to the following:
They will assist the pharmacist in dispensing tasks under direct supervision, in accordance with state and federal lawsThey will assist the pharmacist in the tasks of the Pharmacy Department (prescriptions) in accordance with the company's policies and procedures.Responsible for using the prescription processing system to obtain patient and medication information to process claims to medical plans in a timely and efficient manner.Assist new pharmacy technicians in training the operations of the prescription department.Model and promote excellent patient service, a respectful work environment, and teamwork.Handle phone calls from patients and/or doctors that do not require pharmacist intervention.Make calls to medical plans to complete pre-authorization requirements, validate copayments, covers, and benefits.Assist in managing inventory, purchasing, cleaning, and tidiness of the prescription department, prescription filing, proper storage of medications, and other tasks assigned by the Regent Pharmacist.Responsably comply with all company policies and procedures.Education and Experience:
Associate degree in pharmacy technician.Pharmacy Technician License.Valid Registration Certificate.Minimum of 6 months of experience in community pharmacy..EEOC F/M/V/D
RESUMEN DEL TRABAJO Y RESPONSABILIDADES
El Técnico de Farmacia - ASP es un profesional encargado de recibir y procesar recetas médicas. Brindará a los pacientes los más altos estándares de servicio mientras los asiste e interactúa con ellos. El Técnico de Farmacia - ASP debe cumplir con las normativas de su profesión y mantener sus credenciales actualizadas.
Responsabilidades incluyen, pero no se limitan a:
Asistir al farmacéutico en tareas de dispensación bajo supervisión directa, en cumplimiento con las leyes estatales y federales.Apoyar al farmacéutico en las operaciones del departamento de farmacia (recetas) de acuerdo con las políticas y procedimientos de la empresa.Utilizar el sistema de procesamiento de recetas para recopilar información del paciente y del medicamento, asegurando el envío oportuno y eficiente de reclamaciones a los planes médicos.Capacitar a nuevos técnicos de farmacia en las operaciones del departamento de recetas.Modelar y promover un servicio excepcional al paciente, un ambiente laboral respetuoso y el trabajo en equipo.Atender llamadas telefónicas de pacientes y/o médicos que no requieran intervención del farmacéutico.Realizar llamadas a planes médicos para completar los requisitos de autorización previa, validar copagos, y verificar coberturas y beneficios.Ayudar en la gestión de inventarios, compras, limpieza y organización del departamento de recetas, archivo de recetas, almacenamiento adecuado de medicamentos y otras tareas asignadas por el farmacéutico supervisor.Cumplir responsablemente con todas las políticas y procedimientos de la empresa.Educación y Experiencia:
Grado asociado en Técnico de Farmacia.Licencia de Técnico de Farmacia.Certificado de Registro válido.Mínimo de 6 meses de experiencia en una farmacia comunitaria.EEOC: F/M/V/D
Location: Guaynabo
Responsibilities:
Creation of invoices for managed medicalplans;including but not limited to: FM Medical Vital,MenonitaVital, Triple S (All LOB), Humana, MMM, MCS; among others.Creation of invoices for secondary medical plans and foundations.Handling anduse ofbilling programs.Bill within the required time and in the correct manner.Responsible for the electronic transmission or sending of paper invoices and for accepting and confirming transmitted invoices.Responsible for reviewing, analyzing, and correcting invoices rejected in transmission.Meet the productivity and metricsestablishedin the monthly work plans.Meet the monthly billing close.In charge of investigating and resolving billing problems and referring them to theSupervisor;if necessary.Contact medical offices, patients, and medicalplans;if necessary.Update medical plan circulars.Have up-to-date medical plan rate charts.File sent invoices on paper and deactivate paid cases.Assisting the preparation of patient payment agreements, quotes, or proof of receipt.Required:
High school diploma.Medical Billing Certification. (preferred) or equivalent to 2 years of billing experience.Continuing Education Certificates in the area of billing. (preferred) Read LessLocalidad: Guaynabo PR
Responsabilidades:
Creación de facturas para planes médicos gestionados, incluyendo, entre otros: FM Medical Vital, Menonita Vital, Triple S (todos los LOB), Humana, MMM, MCS.Creación de facturas para planes médicos secundarios y fundaciones.Manejo y uso de programas de facturación.Facturar dentro del plazo requerido y de la manera correcta.Responsable de la transmisión electrónica o el envío de facturas en papel y de aceptar y confirmar las facturas transmitidas.Responsable de revisar, analizar y corregir las facturas rechazadas en la transmisión.Cumplir con la productividad y las métricas establecidas en los planes de trabajo mensuales.Cumplir con el cierre mensual de facturación.Encargarse de investigar y resolver los problemas de facturación y remitirlos al supervisor, si es necesario.Contactar con consultorios médicos, pacientes y planes médicos, si es necesario.Actualizar las circulares de los planes médicos.Disponer de tablas de tarifas de planes médicos actualizadas.Archivar las facturas enviadas en papel y desactivar los casos pagados.Ayudar en la preparación de acuerdos de pago de pacientes, presupuestos o comprobantes de recepción.Requisitos:
Diploma de Escuela Superior Certificación en facturación médica (preferible) o equivalente a 2 años de experiencia en facturación.JOB SUMMARY & RESPONSIBILITIES
The Compliance Analyst is responsible for supporting the organization’s compliance program through monitoring, analysis, investigations, and risk identification activities. This role focuses on ensuring adherence to applicable laws, regulations, internal policies, and contractual requirements, while promoting a culture of integrity, accountability, and continuous improvement. The Compliance Analyst works cross-functionally to identify compliance risks, support mitigation strategies, and enhance the effectiveness of the Quality & Compliance Program.
Responsibilities include, but are not limited to:
Compliance Monitoring & Oversight
Review operational processes and related documentation and controls of pharmacy records and associated claims applying expertise in coding guidelines, medical policies, and payment procedures.Conduct desktop reviews, on-site audits and monitoring activities of the pharmacy network and third-party vendors to ensure the appropriateness of billing practices and compliance with regulatory requirements.Perform contract reviews to evaluate and ensure compliance with all applicable laws, regulations, and specific contractual obligations.Collaborate in the administration of the exclusion list screening process (e.g., OIG, GSA, and other regulatory bodies)Data Analysis & Risk IdentificationCollect, analyze, and interpret data to identify trends, anomalies, and potential compliance risksSupport the development of reports, dashboards, and metrics to monitor compliance performanceReview pharmacy records, claims, prescriptions, employee documentation, contracts, licenses, and other relevant billing-related information to identify potential risks, compliance gaps, and operational improvement opportunities.Investigations & Issue Resolution
Conduct or support investigations related to compliance concerns, including Fraud, Waste, and Abuse (FWA), complaints, inquiries and Social Determinants of Health (SDOH) casesTriage and channel findings from investigations to the appropriate departments for resolution or interventionDocument findings and provide recommendations for corrective actionsRisk Mitigation & Continuous ImprovementAssist in the development and implementation of corrective action plans (CAPA)Monitor effectiveness of corrective actions and identify opportunities for process improvementIdentify and document the root cause that led to the identified error to design the corresponding action planRegulatory & Quality Support
Support regulatory readiness and compliance with accreditation standards (e.g., URAC, ACHC, Joint Commission)Assist with audits, surveys, complaints management and regulatory requests (e.g., RFIs)Ensure adHerence to state and federal laws and regulations, internal policies, and contract requirements.Supports all functions related to Q&C Department internal/external reporting activities.Collects, prepares, reviews, and submits requested information, data, and documents to Executive Management Staff.Collaborate with the Q&C team, as needed to meet department goals, and perform other duties as assigned.Supports the Quality and Compliance Leadership in the administration of the Quality & Compliance Program and objectives.Actively supports Alivia Health Core Values and Mission through professional behavior and daily job performance.May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document.Policies, Procedures & Documentation
Support the development, review, and maintenance of compliance-related policies and proceduresEnsure proper documentation and recordkeeping of compliance activitiesCross-Functional CollaborationCollaborate with business units to address compliance risks and improve processesProvide guidance and support to operational teams on compliance-related mattersAnalyze and review confidential and highly sensitive investigative material/documents concerning insured, prescribers, or employees.Detect and correct potential errors that may result in potential recovery to the company.Give recommendations to the management team for possible solutions or improvement.Training & Awareness
Support compliance training and education initiativesPromote awareness of compliance requirements and ethical standardsDevelop and deliver training programs and awareness material, serving as the primary resource for compliance education and ongoing staff development.Reporting
Prepare and present compliance reports, findings, and recommendations to leadershipEscalate significant compliance risks or issues as appropriatePrepare and submit required fraud, waste, and abuse “FWA” reports to the management team, payors and/or regulatory agencies.Support in the regulatory agencies' request for information “RFI” received.Work with business units’ heads and staff to identify monitoring areas; collect, analyze, and interpret data and report results of monitoring initiatives.Experience:
A minimum of three (3) years’ of experience in pharmacy field and performing audits in billing and coding, pharmacy records review, clinical information extraction, medical terminology, and risk identification in operational areas.Education, Certifications & Licenses:Bachelor’s degree in business administration, Healthcare Administration, Health Sciences, or related field required.Pharmacy Technician associate’s degree.Certifications / Licenses: Certification in billing and coding, such as Certified Coding Associate (CCA), or Certified Coding Specialist (CCS), or Certified Risk Adjustment Coder (CRC), or Certification in Medical Billing, or ICD-10-CM are preferred.Skills:
Ethical leadership skills and able to lead by the values of the organization.Demonstrated emotional intelligence and diplomacy when engaging with others.Demonstrated advanced verbal and written communication skills.Ability to keep sensitive information confidential.Possess a facilitating mindset to build strong customer connectivity.Project management skills.
Demonstrated problem solving skills.The ability to work independently and as part of a team.Ability to maintain objectivity and lack bias in evaluations.Critical thinking ability (analytical) with excellent organizational skills.Detail oriented.Technical Skills:
Knowledge of Microsoft Office programs (Word, Excel, Power Point) is required.Basic knowledge in data analysis technique.Languages:
Fully bilingual in English and Spanish (Written and Verbal) REQUIRED EDUCATION, TRAINING & LICENSURE/CERTIFICATIONSFor Pharmacy Technician it is required to have a license and registration.For other related health Since related field will depend on the specialty and requirements by applicable health boards.PHYSICAL REQUIREMENTS
Must be able to remain in seated position for a large part of the workday.The person in this position needs to occasionally move about inside the office to access other employees, file cabinets, office machinery, etc.An employee must be able to talk, hear, and see, and must be able to grasp and reach objects.Visual acuity is necessary to read and write handwritten and typewritten materials and view a computer terminal.Constantly operates a computer and other office productivity machinery (i.e., a calculator, copy machine, and computer printer). Use of hands (specifically fingers) is necessary for appropriate and efficient computer use.Must be able to lift a minimum ten (10) pounds.Valid driver’s license: safe driving record with the ability to drive during the day and nighttime.***EEOC F/M/V/D***
Read LessEl Especialista de Inventario y Suplido para el Programa de Infusión MQ apoya la gestión y el control de materiales estériles y no estériles, equipos y suministros MQ utilizados en los servicios de infusión, siguiendo las directrices establecidas por la supervisión del programa. Este rol contribuye a mantener la disponibilidad y exactitud del inventario, así como el flujo continuo de suplido hacia las agencias de AIS, residencia de paciente y enfermeros visitantes, asegurando el cumplimiento regulatorio y la coordinación con farmacia, enfermería y suplidores bajo la orientación y revisión continua del supervisor del área.
Responsabilidades:
Apoya el control y mantenimiento del inventario siguiendo los procedimientos y prioridades establecidos por la supervisión del programa.Mantiene los niveles requeridos de materiales de infusión y equipos médicos conforme a las instrucciones y revisiones del supervisor.Documenta entradas, salidas, ajustes y devoluciones en el sistema de inventario clínico bajo los parámetros definidos por la supervisión.Recibe mercancía proveniente de suplidores farmacéuticos y clínicos siguiendo los procedimientos establecidos por la supervisión del programa.Verifica facturas y órdenes de compra para asegurar coincidencia en cantidad y descripción, reportando cualquier discrepancia al supervisor para revisión.Inspecciona los artículos recibidos para identificar daños, defectos o incumplimiento de especificaciones, informando hallazgos para aprobación de acciones correctivas.Cumple con las regulaciones aplicables y las políticas internas siguiendo las guías y prioridades establecidas por la supervisión del programa.Mantiene las áreas de almacenamiento limpias, seguras y organizadas conforme a los estándares definidos por el supervisor.Participa en auditorías internas y externas según lo asignado, siguiendo las instrucciones y prioridades establecidas por la supervisión del programa.Colabora en iniciativas de mejora continua bajo la guía del supervisor, aportando información operativa y ejecutando tareas según se le indique.Realiza tareas operacionales relacionadas según sean asignadas por el supervisor para apoyar la continuidad del programa.Requisitos:
Diploma de Escuela Superior1-3 años en inventario clínico, farmacia, suplido médico o logística en salud.Experiencia previa en recibo, validación y control de inventario.Conocimiento básico de sistemas de inventario clínico o farmacéutico.Conocimiento de regulaciones de salud y manejo seguro de materiales.***Patrono con Igualdad de Oportunidades de Empleo M/H/V/I***
