Pharmacy Prior Authorization & Benefits Specialist

TALENT Software Services

California

Presencial

USD 45.000 - 60.000

Jornada completa

hace 22 horas

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Descripción de la vacante

TALENT Software Services in California is seeking a Pharmacy Tech to support the drug prior authorization program for outpatient pharmacy benefits. You will coordinate procedures, evaluate requests, and communicate with physicians and internal partners to resolve inquiries.

You will provide formulary alternatives and discuss coverage, documenting reviews and supporting case-specific evaluations. Strong proficiency with Word, Teams, Outlook, and Excel is expected, along with CA Pharmacy Tech

Formación

Experience interpreting formulary and prior authorization criteria.
Strong communication with physicians and staff.
Ability to work with internal teams on reviews and inquiries.
Proficient documentation and tracking of pharmacy benefit reviews.

Responsabilidades

Coordinate, assist in, and support implementation of procedures and guidelines for the drug prior authorization program for the outpatient Pharmacy Benefit.
Evaluate prior authorization requests based on medication policy and operational principles.
Provide drug usage history and other pertinent PB-related inquiries to internal business partners to assist in case reviews.
Communicate with physicians, staff, pharmacies, and internal partners to resolve benefit inquiries efficiently.
Clearly communicate formulary alternatives and prior authorization criteria, and discuss coverage when required.