Pharmacy Technician – Seasonal

This is a fully remote position, open to applicants in Arizona, +9 more states.

📋 Description

• Support members, providers, pharmacies, and internal SmithRx teams with prescription-related challenges and ensure timely access to clinically appropriate, cost-effective medication therapies.

• Confirm eligibility and drug coverage under plan benefit designs to facilitate proper claims processing.

• Manage clinical review processes for prior authorization requests in accordance with established protocols.

• Analyze prior authorization requests based on criteria, claims history, and the rules of plan benefits.

• Engage in outreach to prescribers and pharmacies to verify and collect necessary information.

• Organize and prioritize requests to ensure timely management of prior authorization cases.

• Create and modify authorizations within the claim adjudication system.

• Navigate drug products and formulations while conducting basic calculations to ensure accurate claims adjudication.

• Facilitate outreach across teams and address inquiries and escalations.

• Assess clinical situations against medication policies, approving or referring cases to a Pharmacist for denial as needed.

• Identify when medications necessitate internal or external review.

• Reach out to designated external stakeholders for approval on drugs subject to dollar limits.

⛳️ Requirements

• High School diploma or GED, or equivalent work experience.

• Active Pharmacy Technician license is mandatory.

• 2-4 years of experience as a Pharmacy Technician.

• Experience in prior authorization review, particularly on the approval side within a PBM or health plan, is preferred.

• Proficiency in Mac, MS Office, and G-Suite is required.

• Strong critical thinking skills to navigate complex customized benefit plans and make informed clinical decisions.

• Excellent active listening and conversational speaking abilities, demonstrating a high level of empathy.

• Capacity to multitask, prioritize, and manage time efficiently.

• Ability to communicate clearly and convey complex information to members, clients, pharmacies, providers, and internal teams.

• Capability to work accurately within established protocols and adhere to appropriate escalation pathways.

🏝️ Benefits

• Time off programs.

• Medical insurance.

• Dental insurance.

• Vision insurance.

• Mental health support.

• Paid parental leave.

• Life insurance.

• Disability insurance.

• 401(k).

• Potential eligibility for bonuses, commissions, or equity.

• Remote contract employment.