Senior Clinical Pharmacy Technician – MCO Clinical Liaison

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

📋 Description

• Assess and manage prior authorization requests by determining the appropriateness of medications, applying clinical criteria, and communicating outcomes.

• Investigate, address, and document prior authorization results along with complex inquiries from providers and members.

• Oversee intricate care coordination for New York Medicaid members, which includes outreach to providers, resolution of claims, clarification of coverage, and facilitation of prior authorizations.

• Provide education to providers regarding formulary coverage, requirements of the NYRx program, prior authorization processes, and therapeutic alternatives.

• Refer cases needing further clinical review or denial to a pharmacist.

• Offer exceptional customer service while achieving performance, accuracy, and service-level targets.

• Execute the primary responsibilities of the role along with other assigned tasks.

⛳️ Requirements

• High school diploma from an accredited institution or equivalent GED.

• A minimum of 2 years of experience as a pharmacy technician.

• Required certification as a Pharmacy Technician (CPT/ExCPT/LPT/PT/RPT) and compliance with state requirements.

• Must have eligibility to work in the United States without the need for work visa or residency sponsorship.

• Comprehensive understanding of specialty injectable prescription drugs, disease states, formulary management techniques, medical terminology, and reimbursement coding practices.

• Proficient in pharmacy systems, software applications, and Microsoft Office suite.

• Strong written and verbal communication abilities.

• Capability to interpret and apply established clinical criteria and operational guidelines.

• Skilled in identifying, troubleshooting, and resolving operational challenges.

• All employees must adhere to relevant legal, regulatory, contractual, security, and internal policy requirements.

🏝️ Benefits

• Benefits, incentives, and additional compensation options are available; please refer to the Benefits Page.

• We are an equal opportunity and affirmative action employer.

• Reasonable accommodations are provided for employees with disabilities.

• Our workplace is tobacco-free.