Pharmacy Technician – Prior Authorizations

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 resources, existing criteria, and medication guidelines to conduct clinical research that supports prior authorization reviews.

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

• Ensure complete, timely, and accurate documentation is maintained.

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

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

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

• Relay prior authorization status or decisions using computer systems.

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

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

• Work scheduled 8-hour shifts during operating hours from 5:00 a.m. to 8:30 p.m.; overnight shifts may be an option.

• Complete 40 hours weekly, including weekends and holidays as scheduled.

• Be prepared to work extended hours as necessary and participate in a rotating weekend schedule.

⛳️ Requirements

• A National Pharmacy Technician certification and a valid 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 is preferred.

• Ability to multitask and prioritize responsibilities effectively.

• Flexibility to adapt based on business or departmental needs.

• Strong organizational skills.

• A high school diploma or G.E.D. is required.

• Experience in retail or hospital settings is preferred.

• Familiarity with Managed Care or Medicaid is a plus.

• AS400 experience is advantageous.

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

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

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

• Basic knowledge of drug dosage forms, drug strength, and generic and brand name equivalents is preferred.

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

• A secure workspace or office in the home is required.

• High proficiency in working with a PC and navigating multiple systems and screens is necessary.

🏝️ 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.