Job Details

Pharmacy Technician

We are seeking a dedicated Pharmacy Technician to join our team, specializing in working with Medicare and Medicaid patients, primarily focusing on Medicare. The role involves managing prior authorizations, with a focus on intake and tech review processes. This is a fully remote position, providing flexibility and the opportunity to contribute to patient care from the comfort of your home.

Responsibilities

• Manage the intake of MedPharm prior authorizations and set up PAs in the system.
• Send cases to the review tech after initial setup.
• Conduct tech reviews by evaluating PA cases received from the intake team.
• Read and analyze criteria, SOPs, insurance documents, and medical documents to determine eligibility.
• Make clinical determinations regarding medication approval, denial, or coverage.

Essential Skills

• Experience in data entry and pharmacy operations.
• Pharmacy Technician Certification.
• Experience with managed care and claims processing.
• Prior Authorization expertise.
• Strong customer service skills.
• Proficiency in computer skills and the ability to work remotely and independently.

Additional Skills & Qualifications

• Managed care experience.
• Pharmacy experience.
• Ability to handle customer service calls effectively, including controlling and redirecting conversations as needed.
• Cpht certification.

Work Environment

This position is 100% remote, requiring a closed-door setting with limited distractions to maintain HIPAA compliance. A strong Wi-Fi connection is essential to perform duties effectively from home. The initial training schedule is Monday to Friday, 10:00 AM to 6:30 PM EST, with holidays rotating among team members. The preferred working schedule is Tuesday to Friday from 12:30 PM to 9:00 PM EST, and Saturday from 8:00 AM to 4:30 PM EST. Lunch breaks range from 30 minutes to an hour, offering flexibility.

Job Type & Location

This is a Contract to Hire position.

Pay and Benefits

The pay range for this position is $20.00 - $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)

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 ...@actalentservices.com for other accommodation options.