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Remote Pharmacy Technician (Prior Authorization)

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Actalent

3mo ago

  • Job
    Full-time
    Mid Level
  • Customer Relations
    Healthcare
  • Minneapolis

AI generated summary

  • You need 3 years of pharmacy tech or prior authorization experience, 6 months with pharmacy systems, and must have a valid Minnesota pharmacy technician registration.
  • You will review requests for coverage determinations, guide providers and pharmacies on benefits and policies, and manage pharmacy claims without direct member interaction.

Requirements

  • 3 years recent Pharmacy Technician experience that includes familiarity with drugs and drug categories, pharmacy benefits, pharmacy claims, and working with difficult customers in-person and via telephone; or 3 years Prior Authorization and pharmacy benefit experience at a pharmacy benefit company or health plan. Most important factor is being extremely comfortable with drug familiarity.
  • 6 months experience with computer systems in pharmacy services. Need to be able to pick up repeatable processes quickly.
  • Registration as a pharmacy technician in Minnesota - Verify this is active and in good standing at https://pha.hlb.state.mn.us/#/onlineEntitySearch

Responsibilities

  • Reviews requests for medical policy or prescription drugs that require a coverage determination based on pre-determined clinical criteria. Provides guidance to providers (doctors and nurses) as well as pharmacies with regard to pharmacy benefits, pharmacy claims, formulary, and pharmacy policy and procedures. Will not be talking to members.

FAQs

What is the job title for this position?

The job title is Remote Pharmacy Technician (Prior Authorization).

What are the main responsibilities of the Remote Pharmacy Technician?

The main responsibilities include reviewing requests for medical policy or prescription drugs, providing guidance to providers and pharmacies regarding pharmacy benefits and claims, and ensuring adherence to predetermined clinical criteria. The role does not involve direct communication with members.

What experience is required for this position?

A minimum of 3 years of recent Pharmacy Technician experience or 3 years of Prior Authorization and pharmacy benefit experience at a pharmacy benefit company or health plan is required.

Is familiarity with drugs and drug categories important for this role?

Yes, being extremely comfortable with drug familiarity is the most important factor for this position.

What qualifications are highly preferred for this role?

Highly preferred qualifications include the completion of a Pharmacy Technician Program and certification as a Pharmacy Technician (CPhT).

Do applicants need to be registered as a pharmacy technician in Minnesota?

Yes, applicants must be registered as a pharmacy technician in Minnesota and should verify that their registration is active and in good standing.

How much experience with computer systems in pharmacy services is required?

Applicants need to have at least 6 months of experience with computer systems in pharmacy services.

Will I be required to interact with members in this role?

No, the position does not involve talking to members; the focus is on providing support to providers and pharmacies.

Is this position open to remote applicants?

Yes, the position is remote.

What commitment does Actalent have towards diversity and inclusion?

Actalent is committed to diversity, equity, and inclusion, which are embedded in their culture through hiring diverse talent, maintaining an inclusive environment, and ensuring growth opportunities for all employees.

How can a candidate request a reasonable accommodation for the application or interview process?

Candidates can request a reasonable accommodation by emailing actalentaccommodation@actalentservices.com for various accommodation options.

An Engineering and Sciences Services Company | People to Possible

Human Resources
Industry
5001-10,000
Employees

Mission & Purpose

Actalent connects passion with purpose. Our scalable talent solutions and services capabilities drive value and results and provide the expertise to help our customers achieve more. Every day, our experts around the globe are making an impact. We’re supporting critical initiatives in engineering and sciences that advance how companies serve the world. Actalent’s global footprint and flexible delivery models ensure access to specialized talent where and when you need it. We promote consultant engagement through professional development and provide experiences to ensure continuous learning. Our people are the difference. Our expertise spans capabilities in engineering including product and manufacturing, systems and software, construction management, environmental, architecture and civil; and power and utilities. We focus on sciences capabilities in laboratory sciences, healthcare, and clinical research. Actalent is an operating company of Allegis Group, the global leader in talent solutions.