Job Description
We are seeking a dedicated Pharmacy Technician to review Prior Authorizations for a Pharmacy Services department within a large healthcare insurance company. The role involves approving or denying requests and forwarding them to Pharmacists for final review. You will handle various health plans and medication types and occasionally manage phone communications with members, though phone work is minimal.
ResponsibilitiesTrack coverage determination requests submitted by providers and assess if a pharmacist review is necessary.Obtain verbal authorizations and request detailed clinical information from prescribers.Approve coverage determination requests based on defined criteria.Enter and document coverage determination request decisions into the PBM system and notify providers and/or members.Respond to client inquiries regarding authorization approvals and PBM online applications.Refer coverage determination requests for specialty drugs to a delegated vendor or client for processing.Contact providers for additional information to facilitate coverage determination reviews.Notify physicians, providers, and members of coverage determination request decisions.Essential SkillsRegistered Pharmacy Technician in the state of residence.High School diploma or GED.Current Pharmacy Registration and Certification as required by the state of operation.Strong computer skills, including proficiency in Microsoft Office.Experience with prior authorization processes.Customer service and data entry skills.Pay and Benefits
The pay range for this position is $18.00 - $22.00/hr.
Eligibility requirements apply to some benefits and may depend on your job
classification and length of employment. Benefits are subject to change and may be
subject to specific elections, plan, or program terms. If eligible, the benefits
available for this temporary role may include the following:
• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully remote position.
Application Deadline
This position is anticipated to close on Sep 2, 2025.
About Actalent
Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.