Pharmacy Technician – Prior Authorizations

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Job Description:

  • Process prior authorization requests received by phone, fax, or electronically
  • Use computer resources, existing criteria, and medication guidelines to perform clinical research supporting prior authorization reviews
  • Complete prior authorization approvals and denials that are due to expire
  • Maintain complete, timely, and accurate documentation
  • Review potential prior authorization denial language for NCQA compliance
  • Follow prior authorization workflows, policies, and procedures
  • Answer high-volume inquiry calls from provider offices, pharmacies, and internal partners
  • Communicate prior authorization status or decisions using multiple computer resources
  • Maintain productivity, quality, and timeliness of work
  • Participate in required training, continuing education, and team or departmental meetings
  • Work scheduled shifts within Aetna Pharmacy Prior Authorization operating hours of 5:00 a.m. to 8:30 p.m., with possible overnight shifts
  • Demonstrate excellent attendance and support changing schedules based on company needs

Requirements:

  • National Pharmacy Technician certification and Arizona or applicable state Pharmacy Technician license, current and in good standing, are required and must be maintained
  • Between 1-5+ years of Pharmacy Prior Authorization processing experience
  • Ability to multi-task and prioritize work
  • Ability to adjust based on business or department needs
  • Good organization skills
  • High school diploma or G.E.D.
  • Own home internet access with minimum speed of 100 Mbps download
  • Secure workspace/office in the home
  • High-level skill working with a PC and navigating multiple systems and screens
  • Ability to work 40 hours per week, including weekends and holidays
  • Ability to work extended hours when necessary
  • Rotating weekend schedule may be required
  • Retail or Hospital experience preferred
  • Managed Care or Medicaid experience preferred
  • AS400 experience preferred
  • Proficiency with computerized resources and software applications preferred
  • Proficiency with Microsoft applications, including Excel, Word, and Outlook preferred
  • Knowledge of pharmacy practices and procedures and ability to read and understand clinical information preferred
  • Working knowledge of drug dosage forms, drug strength, and generic and brand name equivalents preferred

Benefits:

  • Medical coverage
  • Dental coverage
  • Vision coverage
  • Paid time off
  • Retirement savings options
  • Wellness programs
  • Other resources supporting physical, emotional, and financial well-being, based on eligibility
  • CVS Health bonus, commission or short-term incentive program in addition to base pay
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