Pharmacy Technician – Prior Authorizations

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🔥 0 minutes ago

🌵 Arizona – Remote

🌵 Arizona – Remote

💵 $18 - $35 / hour

⏰ Full Time

🟢 Junior

💊 Pharmacist

🚫👨‍🎓 No degree required

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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 due to expire • 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 • Work scheduled eight-hour shifts within operating hours of 5:00am–8:30pm, including weekends and holidays as scheduled • Work extended hours and rotating weekends when required

🎯 Requirements

• National Pharmacy Technician certification required and must be maintained • Arizona or applicable-state Pharmacy Technician license, current and 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 • Own home internet access with minimum 100 Mbps download speed • Secure workspace/office in the home • High-level PC skills, including using a mouse and keyboard and navigating multiple systems and screens • High school diploma or GED • Preferred: retail or hospital experience • Preferred: managed care or Medicaid experience • Preferred: AS400 experience • Proficiency with computerized resources and software applications • Proficiency with Microsoft Excel, Word, and Outlook • Knowledge of pharmacy practices, procedures, and clinical information • Working knowledge of drug dosage forms, drug strengths, and generic/brand-name equivalents • Proficiency in drug-name and diagnosis pronunciation and recognition of medical terminology • Good written and verbal communication skills • Excellent attendance • Ability to work 40 hours per week, including weekends and holidays as scheduled • Ability to work extended hours when necessary

🏖️ Benefits

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