Pharmacy Technician – Prior Authorizations

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🔥 13 minutes ago

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Logo of CVS Health

CVS Health

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 expiring prior authorization approvals and denials • 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

🎯 Requirements

• National Pharmacy Technician certification required and must be maintained • Current, active Arizona or applicable state Pharmacy Technician license 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 • High-level PC skills, including navigating multiple systems and screens • Own home internet access with minimum 100 Mbps download speed • Secure workspace/office in the home • Ability to work 40 hours per week, including weekends and holidays as scheduled • Ability to work extended hours when necessary • Rotating weekend schedule may be required • Proficiency with computerized resources and software applications • Proficiency with Microsoft Excel, Word, and Outlook • Knowledge of pharmacy practices and procedures • Ability to read and understand clinical information • Working knowledge of drug dosage forms, drug strengths, and generic/brand equivalents • High school diploma or GED • Preferred: retail or hospital experience • Preferred: managed care or Medicaid experience • Preferred: AS400 experience

🏖️ 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

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