Pharmacy Technician – Prior Authorizations

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

📋 Description

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

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

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

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

• Evaluate potential prior authorization denial language for compliance with NCQA standards.

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

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

• Communicate the status or decisions of prior authorizations using various computer resources.

• Uphold productivity, quality, and timeliness in work output.

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

• Work scheduled shifts within Aetna Pharmacy Prior Authorization operating hours, which are from 5:00 a.m. to 8:30 p.m., including potential overnight shifts.

• Exhibit excellent attendance and adapt to changing schedules based on company requirements.

⛳️ Requirements

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

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

• Demonstrate the ability to multitask and prioritize effectively.

• Adaptability to changes based on business or departmental needs is essential.

• Strong organizational skills are required.

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

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

• A secure workspace or office within the home setting is required.

• High-level proficiency in working with a PC and navigating multiple systems and screens is needed.

• Availability to work 40 hours per week, which includes weekends and holidays.

• Willingness to work extended hours when necessary.

• A rotating weekend schedule may be required.

• Experience in Retail or Hospital settings is preferred.

• Preferred experience in Managed Care or Medicaid.

• Familiarity with AS400 is preferred.

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

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

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

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

🏝️ Benefits

• 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.

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