Certified Pharmacy Technician
Actalent
Job Title: Pharmacy TechnicianJob Description
We are seeking a dedicated Pharmacy Technician to review Prior Authorizations and make determinations for a large healthcare insurance company. You will be responsible for approving or denying requests and forwarding them to a Pharmacist for final review. This role involves handling various health plans and medications, with minimal phone work required.
Responsibilities
+ Track coverage determination requests submitted by providers and decide if a pharmacist review is necessary.
+ 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.
Essential Skills
+ High School diploma or GED.
+ Current Pharmacy Registration and Certification as required by the state of operation.
+ Strong computer skills.
+ Prior authorization experience.
+ Proficiency with Microsoft Office, including Outlook.
+ Customer service skills.
+ Registered Pharmacy Technician license.
Additional Skills & Qualifications
+ Nationally Certified Technician.
+ Experience in call center, PBM, hospital, or specialty pharmacy environments.
+ Certification such as CPhT or NHA.
Work Environment
This is a professional remote work environment. You will be working with multiple screens and within multiple systems. A strong WiFi connection and a dedicated office space with a closed door are required. The shift is Monday-Friday, 7am-8pm in your time zone, with rotating weekends and some holidays. Training will be from 10am-6:30pm EST. The schedule will be determined after training, with occasional overtime offered. Equipment such as a computer, monitor, and headset will be provided. Flexibility with the shift is possible if needed.
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.
Diversity, Equity & Inclusion
At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:
+ Hiring diverse talent
+ Maintaining an inclusive environment through persistent self-reflection
+ Building a culture of care, engagement, and recognition with clear outcomes
+ Ensuring growth opportunities for our people
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 (%20actalentaccommodation@actalentservices.com) for other accommodation options.
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