Pharmacy Technician – Prior Authorizations

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

📋 Description

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

• Utilize computer resources, established criteria, and medication guidelines to perform clinical research in support of prior authorization evaluations.

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

• Ensure thorough, timely, and precise documentation.

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

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

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

• Relay prior authorization status or decisions using computer resources.

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

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

⛳️ Requirements

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

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

• Ability to manage multiple tasks and prioritize work effectively.

• Flexibility to adapt based on business or departmental needs.

• Strong organizational skills.

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

• Proficient in the pronunciation of drug names and diagnoses.

• Capability to recognize medical terminology.

• Competence in navigating various computer resources and screens.

• Strong written and verbal communication skills.

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

• Willingness to work extended hours when necessary.

• A rotating weekend schedule may be required.

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

• A secure workspace or office in the home environment.

• Advanced PC skills.

• Experience in retail or hospital settings.

• Familiarity with Managed Care or Medicaid.

• Experience with AS400.

• Proficient with computerized resources and software applications.

• Proficiency in Microsoft Excel, Word, and Outlook.

• Understanding of pharmacy practices and procedures.

• Ability to read and interpret clinical information.

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

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources to support physical, emotional, and financial well-being.