Job Description

🌟 We're Hiring: Pharmacy Prior Authorization Technician! 🌟

We are seeking an experienced Pharmacy Prior Authorization Technician to join our dynamic team. The ideal candidate will possess a strong understanding of pharmacy processes and prior authorization procedures, ensuring timely and accurate approvals for patient medications.

Job Title: Pharmacy Prior Authorization Technician

Client: Health Insurance

Location: Utica/Syracuse/Rochester/Buffalo, NY office – 100% remote work

Target Duration: 6-MONTH CONTRACT possible to extend or convert to FTE.

Summary Description: The Pharmacy Prior Authorization Technician performs functions as permitted by law including the initial level processing and review of prior authorization requests for both pharmacy reviews and medical specialty drug reviews. These reviews are performed utilizing pharmacy management drug policies and procedures. This position accurately prepares and interprets cases for UM (utilization management) reviews and determination. In addition, the Technician is the content expert for the applications used to process these requests. The Technician acts as a resource for staff regarding members specific contract benefits, consistent with products, policies and procedures and related health plan functions such as member services, claims, and the referral/authorization process. This position provides leadership and expertise in the intake area of the prior authorization process for medications processed either through the pharmacy or medical benefit and in processing exception/prior authorization requests that follow standard protocols.

All Levels:

• High school diploma with a minimum of two years experience in health-related field is required. Associates degree preferred.
• Pharmacy Technician certification (CPhT), LPN, Medical Assistant/Technologist background strongly preferred.

Physical Requirements:

• Ability to work prolonged periods sitting at a workstation and working on a computer.
• Ability to work while sitting and/or standing while at a workstation viewing a computer and using a keyboard, mouse and/or phone for three (3) or more hours at a time.
• Typical office environment including fluorescent lighting.
• Ability to work in a home office for continuous periods of time for business continuity.
• Ability to travel across the Health Plan service region for meetings and/or trainings as needed.
• The ability to hear, understand and speak clearly while using a phone, with or without a headset.

In support of the Americans with Disabilities Act, this resource requirements document lists only those responsibilities and qualifications deemed essential to the position.

Ready to make an impact? 🚀 Apply now and let’s grow together!

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