Job Title: Pharmacy Technician

We are seeking a dedicated Pharmacy Technician to join a dynamic Pharmacy Services department within a large healthcare insurance company. This role is 100% remote and involves reviewing Prior Authorizations for determinations, managing health plans, and handling various types of medications. You will be responsible for approving or denying requests and sending them for a pharmacist's final review. Although the position primarily involves desk work, you may occasionally handle phone calls to and from members for certain plans.

• Track coverage determination requests submitted from providers and determine if a pharmacist review is required.
• Obtain verbal authorizations and request detailed clinical information from prescribers.
• Approve coverage determination requests based on defined criteria.
• Enter and document coverage determination request decisions into the PBM system and notify providers and/or members.
• Respond to client inquiries regarding authorization approvals and PBM online applications.
• Refer coverage determination requests for specialty drugs to delegated vendors or clients for processing.
• Contact providers for additional information to facilitate coverage determination reviews.
• Notify physicians, providers, and members of coverage determination request decisions.

• High School diploma or GED.
• Current Pharmacy Registration and Certification as required by the state of operation.
• Strong computer skills, including proficiency in Microsoft Office and Outlook.
• Customer service skills.
• Data entry proficiency.
• Experience with Prior Authorization processes.
• Registered Pharmacy Technician.

• Nationally Certified Technician is a plus and required for some supervisory roles.
• Experience in call centers, PBM, hospitals, or specialty pharmacies.
• Certified Pharmacy Technician (CPhT) and National Healthcareer Association (NHA) certifications.

This is a professional remote environment where you will work across multiple screens and systems. You must have a strong wifi connection and a designated office space with a closed door. The shift requires flexibility, with availability Monday through Friday between 8 am and 7 pm in your time zone, and includes rotating weekends every 4-6 weeks. Some holidays may be required, with schedules determined long-term. Training is conducted from 10 am to 6:30 pm EST, Monday through Friday. The company will provide necessary equipment, including a computer, monitor, and headset. Overtime is not required but may be offered occasionally.