Pharmacy Technician – Prior Authorization

Job not on LinkedIn

🔥 3 minutes ago

🌵 Arizona – Remote

🌵 Arizona – Remote

💵 $18 - $35 / hour

⏰ Full Time

🟢 Junior

💊 Pharmacist

🚫👨‍🎓 No degree required

👻 Ghost score 0%

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 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 prior authorization approvals and denials that are due to expire • Maintain complete, timely, and accurate documentation • Review potential prior authorization denial language to ensure NCQA requirements are met • Follow prior authorization workflows, policies, and procedures • Answer high-volume prior authorization inquiry calls from provider offices, pharmacies, and internal partners • Communicate prior authorization status or decisions using multiple computer resources • Balance productivity, quality, and timeliness of work • Participate in required training, continuing education, and team or departmental meetings

🎯 Requirements

• National Pharmacy Technician certification and Arizona State Pharmacy Technician license, current and in good standing, are required and must be maintained • Between 1-5+ years of Pharmacy Prior Authorization processing experience • Ability to multi-task and prioritize work • Ability to adjust based on business or department needs • Good organization skills • Retail or Hospital experience preferred • Managed Care or Medicaid experience preferred • AS400 experience preferred • Proficiency in using computerized resources and software applications preferred • Proficiency with Microsoft applications (Excel, Word, and Outlook) preferred • Knowledge in pharmacy practices and procedures, and ability to read and understand clinical information preferred • Working knowledge of drug dosage forms, drug strength, and generic and brand name equivalents preferred • High School diploma or G.E.D. • Own home internet access with minimum speed of 100 Mbps download • Secure workspace/office in the home • High-level skill working with a PC and navigating multiple systems and screens • Ability to work 40 hours per week, including weekends and holidays • Ability to work extended hours when necessary • Rotating weekend schedule may be required • Excellent attendance • Good written and verbal communication skills • Proficiency in drug name and diagnosis pronunciation and recognition of medical terminology

🏖️ 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 • Work from home