Pharmacy Authorization Technician

Kelly; City of Rochester (NY); Remote; USD 23,000 - 32,000; Full time

Benefits offered by this job

Medical, dental, vision

Transit benefit

Paid holidays

Retirement savings plan

Job summary

Kelly is seeking a Pharmacy Authorization Technician to support a leading healthcare organization in Greece, NY. This contract role is remote but candidates must reside in the area, with a standard 8am–5pm schedule, Monday–Friday and occasional weekend coverage during the 6–8 month assignment.

You will process and review pharmacy and medical authorization requests, prepare UM case materials, serve as a subject matter expert for related systems, coordinate with pharmacies and physician offices,

Qualifications

• Experience or training in pharmacy operations, healthcare administration, or a related field.

Responsibilities

• Process and review pharmacy and medical authorization requests per policy.
• Prepare, interpret, and document cases for utilization management reviews and determinations.
• Act as a subject matter expert for applications and systems used in the authorization process.
• Serve as a resource for staff regarding member-specific contract benefits, policies, and procedures.
• Conduct medication authorization, exception, and medical necessity reviews to determine coverage and route cases for final determination.
• Issue verbal and written notifications to members.
• Review prescription and medical benefit coverage, document medication histories, and identify missing information.

Skills

Pharmacy operations

Healthcare administration

Attention to detail

Communication skills

Customer service

Job description

At Kelly®, we’re passionate about helping you find a job that works for you. How about this one?

We’re seeking a Pharmacy Authorization Technician to work at a leading healthcare organization in Greece, NY. With us, it’s all about finding the job that’s just right.

Pay Rate: $20.00 per hour (Contract for 6-8 months) - REMOTE position, but must live in the area

Shift: 8am-5pm, Monday-Friday with availability to work 1-2 weekends during 6-8 month contract assignment

What’s a typical day as a Pharmacy Authorization Technician? You’ll be:

• Performing initial processing and review of pharmacy and medical specialty drug authorization requests in accordance with established policies.
• Preparing, interpreting, and documenting cases for utilization management (UM) reviews and determinations.
• Acting as a subject matter expert for applications and systems used in the authorization process.
• Serving as a resource for staff regarding member-specific contract benefits, policies, and procedures.
• Conducting medication authorization, exception, and medical necessity reviews to determine coverage and routing cases for final determination as needed.
• Issuing verbal and written notifications to members.
• Reviewing prescription and medical benefit coverage, documenting medication histories, and identifying missing information to assist clinical staff.
• Communicating with pharmacies, physician offices, and internal staff to clarify authorization requests and facilitate the review process.
• Troubleshooting for the pharmacy help desk, customer care, and claim processors regarding pharmacy and medical claims.
• Performing system testing for upgrades and enhancements to care management systems.
• Triaging authorization workflows and providing phone support for incoming calls related to UM processes.

This Job Might Be An Outstanding Fit If You

• Have experience or training in pharmacy operations, healthcare administration, or a related field (required).
• Possess strong attention to detail and the ability to interpret medical and pharmacy benefit information.
• Are comfortable working with multiple systems and acting as a content expert.
• Demonstrate excellent communication and customer service skills.
• Can prioritize and triage tasks to meet compliance deadlines.
• Are adept at problem-solving and collaborating with clinical and administrative staff.
• Previous experience with utilization management or pharmacy authorization processes is preferred.

As part of our promise to talent, Kelly supports those who work with us through a variety of benefits, perks, and work-related resources. Please note: The following benefits reflect Kelly's general offerings. Eligibility may vary by assignment, location, and job type.

• Kelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability.
• As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account.
• In addition, employees are entitled to earn paid sick leave under the applicable state or local plan.

Kelly may use AI-powered tools during the recruitment and hiring process. For full details, including how Kelly uses AI, your rights, and how to request a reasonable accommodation, visit the Recruitment Artificial Intelligence Notice.

Kelly is committed to providing equal employment opportunities to all qualified employees and applicants regardless of race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, age, marital status, pregnancy, genetic information, or any other legally protected status, and we take affirmative action to recruit, employ, and advance qualified individuals with disabilities and protected veterans in the workforce. Requests for accommodation related to our application process can be directed to the Kelly Human Resource Knowledge Center. Kelly complies with the requirements of California’s state and local Fair Chance laws. A conviction does not automatically bar individuals from employment. Kelly participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S.

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