Pharmacy Technician, Prior Authorization

Accountabilities

• • Review and process prior authorization requests in accordance with established policies, procedures, and decision trees, ensuring accurate and timely handling.
  • Triage and enter incoming authorization requests from provider offices and coordinate the information required for clinical review.
  • Apply preferred product strategies and collaborate with providers to support appropriate utilization of Part B medication benefits.
  • Contact hospitals and provider offices to obtain necessary clinical documentation and follow up on outstanding information.
  • Communicate clinical decisions to provider groups and members while addressing questions and concerns regarding alternative treatment options.
  • Provide operational support across medical management workflows, enabling pharmacists and physicians to make efficient, high-quality decisions.
  • Serve as a key point of contact for internal and external stakeholders and provide workflow support to clinical partners.
  • Interpret plan benefits and process specialty pharmacy overrides to support accurate claim adjudication.
  • Manage multiple priorities in a fast-moving environment while maintaining accuracy, accountability, and high service standards.
  • Work the assigned schedule of 11:30 AM–8:00 PM ET and participate in a mandatory weekend rotation.

  Requirements

  • Hold an active Nationally Certified Pharmacy Technician (CPhT) certification with at least 3 years of professional pharmacy technician experience.
  • Demonstrated experience supporting Medicare Part B operations, such as pharmacy help desk functions, utilization management, or prior authorization.
  • Experience working with Medicare populations and a strong interest in supporting older adults.
  • Prior utilization management experience is preferred.
  • Strong proficiency with technology and digital collaboration tools, including Gmail/G Suite and multiple software systems.
  • Exceptional organization and attention to detail, with the ability to manage several tasks and changing priorities simultaneously.
  • Strong written and verbal communication skills, particularly when working with providers, members, partners, and internal teams.
  • Comfortable operating in a fast-paced environment where priorities can shift quickly and unexpected issues require practical problem-solving.
  • Demonstrated ability to identify process improvements, take ownership of responsibilities, and remain calm and dependable under pressure.
  • A service-oriented, collaborative mindset with the flexibility and agility to adapt throughout the workday.

  Benefits

  • Base pay: $20.90–$26.25 per hour, with actual compensation based on qualifications, experience, skills, education, certifications, and location.
  • Employer-sponsored medical, dental, and vision coverage, with low or no employee premiums depending on the plan.
  • Generous paid time off.
  • $100 monthly mobile or internet stipend.
  • Stock options available to all employees.
  • Bonus eligibility for eligible roles.
  • Parental leave program.
  • 401(k) program.
  • Fully remote/work-from-home position within the United States.
  • Opportunity to contribute to healthcare services supporting an aging population.
  • Total Rewards package applies to eligible full-time employees.