Medicaid Pharmacy Technician — Clinical Review & Authorization

CVS Health; Arizona; Hybrid; USD 26,000 - 48,000; Full time

Benefits offered by this job

Comprehensive benefits

Paid time off

Job summary

CVS Health is seeking a Pharmacy Services Coordinator to support Medicaid/Medicare coordination, intake, and processing of authorization requests. You will evaluate requests under clinical guidelines and communicate decisions to physicians and members.

This role requires a pharmacy tech certification, Home State License, and proficiency with pharmacy systems. Benefits include comprehensive coverage and a structured, collaborative environment.

Qualifications

• Proficiency in computerized pharmacy systems and software applications.
• Excellent verbal and written communication skills.
• Experience with Windows-based software applications.
• Protects the confidentiality of member information and adheres to confidentiality policies.

Responsibilities

• Coordinate Medicaid and/or Medicare pharmacy services intake and processing of authorization requests.
• Evaluate, authorize, and communicate decisions for pharmacy requests per clinical guidelines.
• Determine medication appropriateness and communicate decisions to physicians and staff.
• Perform clinical and non-medical research to support requests and verify eligibility and benefits.
• Maintain documentation meeting regulatory and CMS requirements; escalate complex cases to Pharmacist.

Skills

Communication skills

Pharmacy systems proficiency

Windows software experience

Confidentiality

Education

High School diploma or GED

Tools

Pharmacy software

Job description

CVS Health is seeking a Pharmacy Services Coordinator to support Medicaid/Medicare coordination, intake, and processing of authorization requests. You will evaluate requests under clinical guidelines and communicate decisions to physicians and members.

This role requires a pharmacy tech certification, Home State License, and proficiency with pharmacy systems. Benefits include comprehensive coverage and a structured, collaborative environment.