Clinical Pharmacy Review Technician

PRIME Therapeutics

United States

On-site

USD 32,000 - 51,000

Full time

5 days ago

Be an early applicant

Application generator

A complete application in a minute — tailored resume and cover letter, ready to send.

Get past ATS filters

Job summary

Prime Therapeutics is seeking an Initial Review Pharmacy Technician in the United States. You will review prospective and retrospective requests for therapeutic appropriateness, calling physicians, patients, and pharmacies to collect information and determine medication reimbursement based on clinical criteria.

The role requires 2+ years of pharmacy experience, active licensure or registration, and a relevant certification.

Qualifications

Associate's degree or equivalent required.
2+ years of Pharmacy Experience CPT/ExCPT/LPT/PTCB/RPT.
State requirements: eligible to work in the United States without sponsorship.
Active pharmacy technician licensure or registration per state requirements.
National certification (PTCB/ExCPT) if licensure not required by state.

Responsibilities

Make and receive calls to physicians, patients, and pharmacies to gather clinical information for reimbursement decisions.
Coordinate with operations, clinical, medical, and other internal teams as needed.
Review patient information and determine applicability using clinical criteria.
Make approval recommendations for services meeting criteria.
Escalate non-qualifying cases to pharmacist reviewers.
Document communications and maintain clinical records and edits.
Provide consultation on pharmacy-related questions to resolve claims submissions.