At least 5 years
This role is STARs-friendly: Skilled Through Alternative Routes.
73% STARs in role.
Job Title: Remote Pharmacy Technician
Job Description
This role focuses on tracking and triaging coverage determination requests for prior authorizations, primarily for Medicare Part D recipients. The Pharmacy Technician I supports the pharmacy benefit management process by reviewing requests, gathering clinical information, and documenting decisions in the pharmacy benefit management (PBM) system while providing clear communication to providers, members, and internal stakeholders.
Responsibilities
- Track and triage coverage determination requests submitted by providers for prior authorizations, particularly for Medicare Part D recipients.
- Review incoming coverage determination requests and determine whether a pharmacist’s clinical review is required based on established guidelines.
- Obtain verbal authorizations from prescribers and request detailed clinical information needed to support coverage determination decisions.
- Approve coverage determination requests in accordance with defined criteria and organizational policies.
- Accurately enter and document coverage determination decisions in the PBM system, ensuring all required information is complete and up to date.
- Notify providers and members of coverage determination decisions in a timely and professional manner.
- Respond to client inquiries regarding authorization approvals and PBM online processes, providing clear and accurate information.
- Refer coverage determination requests for specialty medications to the appropriate delegated vendor or client for processing, following established workflows.
- Contact providers to obtain additional information when needed to facilitate thorough and accurate coverage determination reviews.
- Communicate coverage determination outcomes to physicians, providers, and members, ensuring they understand the decision and any next steps.
Essential Skills
- High school diploma or equivalent.
- At least 5 year of experience in a retail or prior authorization experience
- Current state Pharmacy Technician license.
- Current PTCB license
Work Environment
This position operates in a professional pharmacy or pharmacy benefit management office environment that is focused on processing coverage determinations efficiently and accurately. Work typically involves extensive use of computers and PBM or related healthcare information systems for data entry, documentation, and communication. The role requires frequent phone and electronic communication with providers, members, and clients. The schedule generally follows standard business hours, with expectations to manage workloads and respond promptly to incoming requests and inquiries. Attire is professional and appropriate for an office-based healthcare setting.
Job Type & LocationThis is a Contract position based out of San Antonio, TX.
Pay and BenefitsThe pay range for this position is $18.00 - $20.00/hr.
Eligibility requirements apply to some benefits and may depend on your job
classification and length of employment. Benefits are subject to change and may be
subject to specific elections, plan, or program terms. If eligible, the benefits
available for this temporary role may include the following:
• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)
This is a fully remote position.
Application DeadlineThis position is anticipated to close on Jun 16, 2026.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.
San Francisco Fair Chance Ordinance: Pursuant to the San Francisco Fair Chance Ordinance, for all positions located in the city and county of San Francisco, we will consider for employment qualified applicants with arrest and conviction records.
Massachusetts Lie Detector: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
Use of Artificial Intelligence (AI): We may use Artificial Intelligence (AI) to support parts of our hiring process, including sourcing, screening, and evaluating candidates. AI helps assess applications and qualifications, but final decisions are made by our hiring team. By applying, you acknowledge and agree that your application may be reviewed using AI tools.
Posting ID: JP-006070140
