Pharmacy Technician – Prior Authorization

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

📋 Description

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

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

• Finalize prior authorization approvals and address pending denials before expiration.

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

• Assess potential prior authorization denial language to confirm compliance with NCQA standards.

• Adhere to prior authorization workflows, policies, and protocols.

• Respond to a high volume of prior authorization inquiry calls from provider offices, pharmacies, and internal stakeholders.

• Convey prior authorization statuses or decisions utilizing computer systems.

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

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

• Uphold excellent attendance records.

• Be available to work shifts within Aetna Pharmacy Prior Authorization operating hours from 5:00 am to 7:00 pm, including potential overnight shifts.

• Be prepared to work weekends and holidays as required by company needs.

⛳️ Requirements

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

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

• Strong ability to multi-task and prioritize tasks effectively.

• Flexibility to adjust according to business or departmental requirements.

• Excellent organizational skills.

• Experience in retail or hospital settings is preferred.

• Managed Care or Medicaid experience is preferred.

• Familiarity with AS400 systems is preferred.

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

• Strong skills in Microsoft applications (Excel, Word, and Outlook) are preferred.

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

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

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

• Access to home internet with a minimum download speed of 100 Mbps is required.

• A secure workspace/office in the home is necessary.

• High-level PC skills, including proficiency in using a mouse and keyboard and navigating multiple systems and screens.

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

• Willingness to work extended hours when necessary.

• Flexibility to work rotating weekends if required.

🏝️ Benefits

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

• Medical insurance coverage.

• Dental insurance coverage.

• Vision insurance coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

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