Pharmacy Technician – Prior Authorizations

Job Description:

  • Process prior authorization requests received by phone, fax, or electronically
  • Use computer resources, existing criteria, and medication guidelines to perform clinical research supporting prior authorization reviews
  • Complete expiring prior authorization approvals and denials
  • Maintain complete, timely, and accurate documentation
  • Review potential prior authorization denial language for NCQA compliance
  • Follow prior authorization workflows, policies, and procedures
  • Answer high-volume inquiry calls from provider offices, pharmacies, and internal partners
  • Communicate prior authorization status or decisions using computer resources
  • Balance productivity, quality, and timeliness
  • Participate in required training, continuing education, and team or departmental meetings

Requirements:

  • National Pharmacy Technician certification required and must be maintained
  • Current, active Arizona or applicable state Pharmacy Technician license in good standing required and must be maintained
  • 1–5+ years of Pharmacy Prior Authorization processing experience
  • Ability to multitask and prioritize work
  • Ability to adjust based on business or department needs
  • Good organizational skills
  • High-level PC skills, including navigating multiple systems and screens
  • Own home internet access with minimum 100 Mbps download speed
  • Secure workspace/office in the home
  • Ability to work 40 hours per week, including weekends and holidays as scheduled
  • Ability to work extended hours when necessary
  • Rotating weekend schedule may be required
  • Proficiency with computerized resources and software applications
  • Proficiency with Microsoft Excel, Word, and Outlook
  • Knowledge of pharmacy practices and procedures
  • Ability to read and understand clinical information
  • Working knowledge of drug dosage forms, drug strengths, and generic/brand equivalents
  • High school diploma or GED
  • Preferred: retail or hospital experience
  • Preferred: managed care or Medicaid experience
  • Preferred: AS400 experience

Benefits:

  • Medical coverage
  • Dental coverage
  • Vision coverage
  • Paid time off
  • Retirement savings options
  • Wellness programs
  • Other resources supporting physical, emotional, and financial well-being
  • CVS Health bonus, commission or short-term incentive program eligibility
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