Hybrid/Remote Prior Authorization Pharmacy Tech II

Elevance Health, Inc.; Oregon; Hybrid; USD 36,000 - 52,000; Full time

Job summary

Elevance Health, Inc. is seeking a Prior Authorization Pharmacy Technician II to interpret and data-enter moderately complex prescriptions, handle prior authorization processing, and troubleshoot adjudication issues.

The role supports pharmacists and ensures compliance with Medicare requirements while assisting physicians, members, and the sales team. Ideal candidates will hold an active pharmacy technician license and a HS diploma with 2+ years of pharmacy experience.

Qualifications

• Requires active professional license or certification as a Pharmacy Technician as per state requirements.
• Requires a High School diploma or equivalent and at least 2 years of pharmacy experience, or equivalent combination of education/experience.
• URAC areas require strong communication, problem-solving, facilitation and analytical skills.

Responsibilities

• Verifies member information and inputs data for the pharmacists.
• Educates members on pharmacy rules related to prescriptions and medication resources or assistance programs.
• Processes prior authorization requests from physician offices and ensures Medicare compliance; informs parties of determinations.
• Provides resolution to grievances and appeals issues.
• Responds to inquiries from physicians, sales team, and members related to formulary and prescription benefits.
• Maintains record keeping of prior authorizations, rebates, and monthly reports.

Skills

Pharmacy experience

Prior authorization

Data entry

Communication

Education

High School Diploma

Pharmacy Technician Certification

Job description

Elevance Health, Inc. is seeking a Prior Authorization Pharmacy Technician II to interpret and data-enter moderately complex prescriptions, handle prior authorization processing, and troubleshoot adjudication issues.

The role supports pharmacists and ensures compliance with Medicare requirements while assisting physicians, members, and the sales team. Ideal candidates will hold an active pharmacy technician license and a HS diploma with 2+ years of pharmacy experience.