Contract Clinical Services Support Technician

This is a fully remote position, open to applicants in Alabama, +45 more states.

📋 Description

• Synchronize Medispan drug lists within the drug list management system.

• Revise prior authorization coverage criteria documents to reflect formulary updates and client-specific customizations.

• Manage quantity limit rules and execute client-specific modifications.

• Investigate claim rejections tied to drug list platform configuration and address inquiries regarding clinical drug list and benefit setup.

• Elevate issues that necessitate clinical review.

• Prepare and disseminate coverage policy documents and printed client drug lists under the oversight of clinical quality assurance.

• Establish quality control checkpoints for updates on prior authorization, cleanup of quantity limits, and printing of prior authorizations.

• Analyze, create, and distribute medication lists and reports.

• Develop client-facing clinical materials, including disruption analyses for annual and quarterly business reviews.

• Collaborate with pharmacists, operational teams, and internal stakeholders to meet project deadlines.

• Identify opportunities to enhance accuracy and efficiency via technology, automation, and AI-driven tools.

⛳️ Requirements

• High school diploma or equivalent qualification.

• Active Certified Pharmacy Technician (CPhT) certification from PTCB or ExCPT, along with state registration or licensure as applicable.

• Minimum of 3 years of experience as a pharmacy technician.

• At least 2 years of experience with a pharmacy benefit manager (PBM) in roles supporting clinical services, such as utilization management, coverage review, or prior authorization resolution.

• Familiarity with mail order and specialty pharmacy operations, prior authorization support, formularies, drug lists, and National Drug Code (NDC) identifiers.

• Practical experience with formulary or drug information databases and PBM platforms.

• Proficient in Microsoft Excel and PowerPoint.

• Strong attention to detail and accuracy when maintaining claims adjudication data and preparing client-facing documents, including disruption analyses, benefit summaries, and business review presentations.

• Excellent follow-through and effective written and verbal communication skills to coordinate with pharmacists, operations teams, and internal stakeholders while adhering to deadlines in a high-volume environment.

• Sound judgment in determining what can be resolved independently and when pharmacist review is necessary.

• Eagerness to learn and grow, with a willingness to embrace technology, automation, and AI-enabled tools.

🏝️ Benefits

• Prescryptive will provide a laptop for the duration of the contract.

• This position is a contract role and is therefore not eligible for Prescryptive employee benefits.