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 electronically.

• Utilize computer tools, established criteria, and medication guidelines to conduct clinical research for prior authorization evaluations.

• Finalize prior authorization approvals and denials that are nearing expiration.

• Ensure documentation is complete, timely, and accurate.

• Evaluate potential denial language for NCQA compliance in prior authorizations.

• Adhere to established workflows, policies, and procedures for prior authorization.

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

• Relay prior authorization status or decisions through computer resources.

• Maintain productivity, quality, and timeliness in all tasks.

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

• Work scheduled shifts during Aetna Pharmacy Prior Authorization operating hours from 5:00am to 7:00pm, including possible overnight shifts.

⛳️ Requirements

• National Pharmacy Technician certification and a valid Arizona State Pharmacy Technician license, both current and in good standing, are mandatory and must be maintained.

• 1 to 5+ years of experience in Pharmacy Prior Authorization processing.

• Capability to multi-task and prioritize various tasks.

• Flexibility to adjust according to business or departmental requirements.

• Strong organizational skills.

• Experience in Retail or Hospital settings is preferred.

• Familiarity with Managed Care or Medicaid is preferred.

• AS400 experience is preferred.

• Proficient in using computerized resources and software applications is preferred.

• Proficiency with Microsoft applications (Excel, Word, and Outlook) is preferred.

• Knowledge of pharmacy practices and procedures, with the ability to comprehend clinical information, is preferred.

• Understanding of drug dosage forms, drug strengths, and both generic and brand name equivalents is preferred.

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

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

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

• High-level skills in working with a PC and navigating multiple systems and screens are essential.

• Ability to work 40 hours per week, including weekends and holidays.

• Willingness to work extended hours when needed.

• A rotating weekend schedule may be required.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program in addition to the base pay range.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources supporting physical, emotional, and financial well-being, based on eligibility.