Pharmacy Technician – Prior Authorization

This is a fully remote position, open to applicants in Arizona.

📋 Description

• Manage prior authorization requests received via phone, fax, or electronic means.

• Utilize computer tools, established criteria, and medication guidelines to perform clinical research that supports prior authorization evaluations.

• Finalize prior authorization approvals and address imminent denials.

• Ensure thorough, timely, and precise documentation is maintained.

• Evaluate potential denial language for prior authorizations to ensure compliance with NCQA standards.

• Adhere to established workflows, policies, and procedures related to prior authorizations.

• Handle a high volume of inquiry calls from provider offices, pharmacies, and internal stakeholders.

• Relay prior authorization status or decisions using computer tools.

• Maintain a balance between productivity, quality, and promptness.

• Engage in mandatory training, continuing education, and team or departmental meetings.

• Work scheduled shifts within Aetna Pharmacy Prior Authorization operational hours of 5:00 a.m. to 7:00 p.m., with the possibility of overnight shifts.

• Pronounce medication names and diagnoses accurately, recognize medical terminology, and document discussions and decisions effectively.

⛳️ Requirements

• Must possess a National Pharmacy Technician certification and a current, valid Arizona State Pharmacy Technician license.

• Have between 1-5+ years of experience in Pharmacy Prior Authorization processing.

• Capable of multitasking and prioritizing tasks effectively.

• Ability to adapt based on the needs of the business or department.

• Strong organizational skills are essential.

• High school diploma or G.E.D. is required.

• Must have home internet access with a minimum download speed of 100 Mbps.

• A secure workspace or office environment at home is necessary.

• Proficient in using a PC and navigating multiple systems and screens.

• Availability to work a scheduled 40 hours per week, including weekends and holidays.

• Willingness to work extended hours when required.

• A rotating weekend schedule may be necessary.

🏝️ Benefits

• Participation in CVS Health bonus, commission, or short-term incentive programs in addition to base pay.

• Comprehensive medical coverage.

• Dental insurance offerings.

• Vision insurance coverage.

• Paid time off benefits.

• Retirement savings options available.

• Access to wellness programs.

• Additional resources promoting physical, emotional, and financial well-being, subject to eligibility.