Clinical Pharmacy Technician

🕒 July 24

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

💊 Pharmacist

👻 Ghost score 25%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Medical Review Institute of America, LLC

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1983

🛡️ Insurance

💼 Consulting

⚖️ Legal

Insurance • Consulting • Legal

Medical Review Institute of America, LLC is a company specializing in clinical and utilization review services. They offer a comprehensive suite of data-driven solutions, including prior authorization optimization, second opinions, and specialty drug reviews, aimed at ensuring the right care is delivered at the right time and in the right place. MRIoA provides services to health plans, pharmacy benefit managers, government entities, and self-insured employers, among others. They leverage technology and a network of professionals to streamline clinical decisions, enhance provider performance, and ensure compliance with regulatory requirements across all 50 states. Their tools and platforms are designed to optimize clinical reviews, reduce costs, and improve patient outcomes through evidence-based care pathways and telehealth solutions.

📋 Description

• Process and finalize prior authorization requests within clients’ turnaround time and Performance Guarantees using guidelines • Enter prior authorizations into the system and prioritize requests • Check formulary alternatives and review tried and failed medications • Utilize drug references and verify requested drugs are indicated and approved for the condition • Document information regarding PA approval or non-approval, status, and related details • Partner with assigned clinical pharmacists while adhering to administrative-processing boundaries and timeframes • Analyze, research, and resolve prior authorization processing issues • Contact clients, members, physicians, and pharmacies by telephone or in writing to obtain information • Refer unique or high-dollar requests to supervisors according to guidelines • Coordinate outbound communication to members, physicians, and pharmacies to obtain missing information and manage pending requests • Make outbound calls to obtain information and answer questions about prior authorization status • Protect and maintain confidentiality and privacy of prior authorization and member information • Identify and recommend operational improvements • Participate in applicable Quality Management initiatives • Maintain a flexible schedule to meet client needs • Support Compliance Program activities • Complete other duties as directed • At higher levels, manage PANF reports, daily assignments, LOI, and Outreach calls; support audits; train and mentor colleagues; lead committees or pilot process improvements; and provide floor coverage without a supervisor

🎯 Requirements

• Ability to work in a fast-paced and high-functioning environment and meet deadlines while managing multiple high priorities • Moderate-to-high level of medication and disease state knowledge within the scope of pharmacy practice • Personal computer literacy and high competency in using Microsoft Word, Excel, Adobe, etc. • Strong organizational skills with attention to detail • Strong oral and written communication skills • Excellent critical thinking capabilities with a strong attention to detail • Exceptional customer service skills • Minimum one-year prior authorization experience preferred • Health plan or Pharmacy Benefit Manager experience preferred • High school diploma or equivalent • Active Certified Pharmacy Technician (State or National License) • Ability to sit at a desk and utilize a computer, telephone, and other basic office equipment • Ability to pass a Background Screen before beginning employment • Newly hired employees must take a Drug Screen • Agreement to necessary Compliance Regulations on the first day of employment • Adherence to applicable HIPAA regulations and company confidentiality, privacy, and security policies

🏖️ Benefits

• A competitive compensation package • Benefits include healthcare, vision, and dental insurance • A generous 401(k) match • Paid vacation, PTO, and holidays • Growth and training opportunities • An award-winning remote work environment